NPIMap

Individual provider Active NPI

Scott D Fairweather, LISW-CP, CAC-I

  • Clinical Social Worker
  • Columbia, SC
National Provider Identifier
1790812485
Registry record updated Sep 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8866 Issued in SC
Practice address
15 Medical Park
Suite 300
Columbia, SC 29203-6894
Phone
(803) 434-4300
NPI assigned
Feb 28, 2007
Last updated
Sep 30, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2010

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1005207 SC
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X 8866 SC
Clinical Social Worker 1041C0700X 8866 SC Primary

Addresses

Primary practice location

15 Medical Park
Suite 300
Columbia, SC 29203-6894

Mailing address

15 Medical Park
Suite 300
Columbia, SC 29203-6894
Phone (803) 434-4300

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

State licenses

LicenseStateTypeSpecialty
1005207SCMDAddiction (Substance Use Disorder) Counselor
8866SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Illness Recovery Center Past Accepting new patients
Counseling & Consultant Services LLC Clinical Past Accepting new patients
Angela D. Harper, M.D., PA Past Accepting new patients
University Specialty Clinics - Neuropsychiatry and Behavioral Science Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/7878c7ba-d1a3-4bd2-9b45-7234d7142c12/

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.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285804800000",
    "number": "1790812485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 MEDICAL PARK",
            "address_2": "SUITE 300",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036894",
            "telephone_number": "803-434-4300",
            "fax_number": "803-434-4351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MEDICAL PARK",
            "address_2": "SUITE 300",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036894",
            "telephone_number": "803-434-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRWEATHER",
        "first_name": "SCOTT",
        "middle_name": "D",
        "credential": "LISW-CP, CAC-I",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2010-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "SC",
            "license": "1005207",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "8866",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "8866",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.