NPIMap

Organization Active NPI

Wil Lou Gray Opportunity School

  • Local Education Agency (LEA)
  • West Columbia, SC
National Provider Identifier
1710023833
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Local Education Agency (LEA)Taxonomy code 251300000X
Legal business name
WIL LOU GRAY OPPORTUNITY SCHOOL
Practice address
3300 W Campus Rd
West Columbia, SC 29170-2134
Phone
(803) 896-6480
Fax
(803) 896-6494
NPI assigned
Jan 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Gloria Robinson
Title
Director of Medical Services
Phone
(803) 896-6472

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Local Education Agency (LEA) 251300000X Primary

Addresses

Primary practice location

3300 W Campus Rd
West Columbia, SC 29170-2134

Mailing address

3300 W Campus Rd
West Columbia, SC 29170-2134
Phone (803) 896-6480

Other identifiers 1

IdentifierTypeStateIssuer
VR0001MedicaidSC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2236540Wil Lou Gray Opportunity School3300 West Campus Road, West Columbia, SC 29170Certificate of waiverSep 16, 2027

National Provider Directory

National Provider Directory
Tax ID family
SC Dept of Health and Environmental Control280 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

3300 W Campus Rd
West Columbia, SC 29170
Phone (803) 896-6462

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710023833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 W CAMPUS RD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291702134",
            "telephone_number": "803-896-6480",
            "fax_number": "803-896-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 W CAMPUS RD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291702134",
            "telephone_number": "803-896-6480",
            "fax_number": "803-896-6494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIL LOU GRAY OPPORTUNITY SCHOOL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "DIRECTOR OF MEDICAL SERVICES",
        "authorized_official_telephone_number": "803-896-6472",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "VR0001",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.