Active NPI
John M Iaquinto, MD
- Orthopaedic Trauma Physician
- Columbia, SC
National Provider Identifier
1720020639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Trauma Physician
- License
- 30693
- Practice address
- 3 Medical Park
Ste. 330
Columbia, SC 29203 - Phone
- (803) 296-7305
- NPI assigned
- Jun 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 2005010201 | MO | |
| Orthopaedic Trauma Physician | 207XX0801X | 2005010201 | MO | |
| Orthopaedic Trauma Physician | 207XX0801X | 30693 | SC | Primary |
Addresses
Primary practice location
3 Medical Park
Ste. 330
Columbia, SC 29203
Mailing address
PO Box 370
Fortson, GA 31808-0370
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01-0838370 | Other | MO | COVENTRY |
| 207429408 | Medicaid | MO | |
| 35477015 | Other | MO | BCBS(PHP) RMC LOCATION |
| 56779 | Other | MO | HEALTHCARE USA-MIDWEST LO |
| 200326830A | Medicaid | KS | |
| 35477025 | Other | MO | BCBS(PHP) MIDWEST TRAUMA |
| 4403943 | Other | MO | AETNA |
| 76-0726650 | Other | MO | HUMANA |
| 200326830B | Medicaid | KS | |
| 306939 | Medicaid | SC | |
| 925760 | Other | MO | FIRST GUARD-RMC LOCATION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5230 | SD | MD | Pharmacist |
| 2005010201 | MO | MD | Orthopaedic Surgery Physician |
| 30693 | SC | MD | Orthopaedic Trauma Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RMC HBP, LLC | Past | Accepting new patients | |
| Livingston Healthcare | Past | Accepting new patients | |
| Livingston Healthcare | Past | Accepting new patients | |
| Midwest Trauma Services, LLC | Past | Accepting new patients |
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.
-
dba Livingston HealthCare Gardiner
- Rehabilitation Clinic/Center
- Gardiner, MT
- NPI 1225670375
-
- Critical Access Hospital
- Livingston, MT
- NPI 1245222306
-
dba Midwest Trauma & Surgical Specialists
- Trauma Surgery Physician
- Kansas City, MO
- NPI 1063468361
-
dba dba: RMC Pulmonary Physicians
- Pulmonary Disease Physician
- Kansas City, MO
- NPI 1508855602
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591228800000",
"number": "1720020639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 370",
"city": "FORTSON",
"state": "GA",
"postal_code": "318080370",
"fax_number": "706-494-3008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 MEDICAL PARK",
"address_2": "STE. 330",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "29203",
"telephone_number": "803-296-7305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IAQUINTO",
"first_name": "JOHN",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-12",
"last_updated": "2020-06-04",
"certification_date": "2020-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "MO",
"license": "2005010201",
"primary": false
},
{
"code": "207XX0801X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Orthopaedic Trauma",
"state": "MO",
"license": "2005010201",
"primary": false
},
{
"code": "207XX0801X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Orthopaedic Trauma",
"state": "SC",
"license": "30693",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COVENTRY",
"identifier": "01-0838370",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "207429408",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS(PHP) RMC LOCATION",
"identifier": "35477015",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHCARE USA-MIDWEST LO",
"identifier": "56779",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200326830A",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS(PHP) MIDWEST TRAUMA",
"identifier": "35477025",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4403943",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "76-0726650",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200326830B",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "306939",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST GUARD-RMC LOCATION",
"identifier": "925760",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.