NPIMap

Individual provider Active NPI

Edward E Kimbrough, MD

  • Gastroenterology Physician
  • Columbia, SC
National Provider Identifier
1699756619
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
19738 Issued in SC
Practice address
2739 Laurel St Ste 1a
Columbia, SC 29204-2028
Phone
(803) 799-4800
Fax
(803) 252-0052
NPI assigned
Nov 8, 2005
Last updated
Aug 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 19738 SC Primary

Addresses

Primary practice location

2739 Laurel St Ste 1a
Columbia, SC 29204-2028

Mailing address

2739 Laurel St Ste 1a
Columbia, SC 29204-2028
Phone (803) 799-4800

Other identifiers 1

IdentifierTypeStateIssuer
197389MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100212000585 SC Practitioner - GastroenterologyPractitioner - Internal Medicine 1153465299 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Medical University of South Carolina College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia Gastroenterology Associates PAGroup PAC ID 9234035759, 10 clinicians

Practice addresses (Care Compare)

2739 Laurel St
Suite 1a
Columbia, SC 29204-2028
Phone (803) 799-4800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy197
Upper gastrointestinal (GI) endoscopy for acid reflux219

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
19738SCMDFamily Nurse Practitioner
19737SCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands CurrentSince Sep 1, 2016 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Sep 1, 2016 Accepting new patients
Columbia Gastroenterology Associates PA Gastroenterology CurrentSince Apr 1, 2020 Accepting new patients
Palmetto Health Past Accepting new patients

Locations

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

2739 Laurel St
Ste 1A
Columbia, SC 29204
Phone (803) 799-3737

Interoperability endpoints

  • Direct secure messaging: ekimbrough424014@direct.musc.edu

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1699756619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2739 LAUREL ST STE 1A",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042028",
            "telephone_number": "803-799-4800",
            "fax_number": "803-252-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2739 LAUREL ST STE 1A",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042028",
            "telephone_number": "803-799-4800",
            "fax_number": "803-252-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBROUGH",
        "first_name": "EDWARD",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "SC",
            "license": "19738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197389",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.