Organization Active NPI

South Carolina Internal Medicine Associates and Rehabilitation,L.L.C.

  • Internal Medicine Physician
  • Irmo, SC
National Provider Identifier
1760483382
Registry record updated May 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11901 Issued in SC
Legal business name
SOUTH CAROLINA INTERNAL MEDICINE ASSOCIATES AND REHABILITATION,L.L.C.
Practice address
7182 Woodrow St Ste 200
Irmo, SC 29063-2958
Phone
(803) 749-1111
Fax
(803) 749-0050
NPI assigned
Aug 4, 2005
Last updated
May 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2024

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

Authorized official

Name
Benjamin J Levinson, MDNPI 1346208865
Title
Manageing Partner
Phone
(803) 749-1111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MPA 1942 TL SC
Adult Medicine Physician 207QA0505X 11481 SC
Internal Medicine Physician 207R00000X 11931 SC
Internal Medicine Physician 207R00000X 21980 SC
Internal Medicine Physician 207R00000X 11901 SC Primary
Cardiovascular Disease Physician 207RC0000X 11871 SC
Physical Medicine & Rehabilitation Physician 208100000X 17388 SC
Surgery Physician 208600000X 10531 SC

Addresses

Primary practice location

7182 Woodrow St Ste 200
Irmo, SC 29063-2958

Mailing address

7182 Woodrow St Ste 200
Irmo, SC 29063-2832
Phone (803) 749-1111

Other practice location 1

7021 Saint Andrews Rd # 2
Columbia, SC 29212-1177
Phone (803) 749-1111

Other practice location 2

1 Wellness Blvd Ste 109
Irmo, SC 29063-2872
Phone (803) 749-1111

Other practice location 3

1 Wellness Blvd Ste 202
Irmo, SC 29063-2873
Phone (803) 749-1111

Other identifiers 4

IdentifierTypeStateIssuer
110188005OtherSCRAILROAD MEDICARE
GP2478MedicaidSC
1760483382OtherSCRAILROAD MEDICARE
CI9660OtherSCRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040525000145 SC Part B Supplier - Clinic/Group Practice 1759362072 Receives reassigned benefits from 34 practitioners
Practice locations: Irmo, SC; Columbia, SC

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
42D2303530South Carolina Internal Medicine Associates1 Wellness Blvd, Suite 109, Irmo, SC 29063Certificate of waiverApr 25, 2028

National Provider Directory

National Provider Directory

Locations

1901 Main St
#1105
Columbia, SC 29201

2611 Forest Dr
Ste 230
Columbia, SC 29204
Phone (803) 252-6644

7021 Saint Andrews Rd
#2
Columbia, SC 29212
Phone (803) 749-1111

Practitioners & affiliated clinicians

Practitioners 40

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1123113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714867200000",
    "number": "1760483382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7182 WOODROW ST STE 200",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632832",
            "telephone_number": "803-749-1111",
            "fax_number": "803-749-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7182 WOODROW ST STE 200",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632958",
            "telephone_number": "803-749-1111",
            "fax_number": "803-749-0050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7021 Saint Andrews Rd # 2",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292121177",
            "country_code": "US",
            "telephone_number": "803-749-1111",
            "fax_number": "803-749-0050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Wellness Blvd Ste 109",
            "address_purpose": "LOCATION",
            "city": "Irmo",
            "state": "SC",
            "postal_code": "290632872",
            "country_code": "US",
            "telephone_number": "803-749-1111",
            "fax_number": "803-749-0050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Wellness Blvd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Irmo",
            "state": "SC",
            "postal_code": "290632873",
            "country_code": "US",
            "telephone_number": "803-749-1111",
            "fax_number": "803-749-0050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTH CAROLINA INTERNAL MEDICINE ASSOCIATES AND REHABILITATION,L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-04",
        "last_updated": "2024-05-05",
        "certification_date": "2024-05-05",
        "status": "A",
        "authorized_official_last_name": "LEVINSON",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGEING PARTNER",
        "authorized_official_telephone_number": "803-749-1111",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "MPA 1942 TL",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "SC",
            "license": "11481",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "11931",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "21980",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "11901",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "SC",
            "license": "11871",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "SC",
            "license": "17388",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "10531",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110188005",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2478",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "1760483382",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI9660",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irmo, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.