NPIMap

Individual provider Active NPI

Mariagoretti Lumnwi Niba, DNP

  • Family Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1801407325
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
24275 Issued in SC
Practice address
1301 Taylor St Ste 1a
Columbia, SC 29201-2946
Phone
(803) 434-4790
Fax
(803) 434-4799
NPI assigned
Aug 10, 2020
Last updated
Mar 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 214982 LA
Family Nurse Practitioner 363LF0000X 24275 SC Primary

Addresses

Primary practice location

1301 Taylor St Ste 1a
Columbia, SC 29201-2946

Mailing address

PO Box 743904
Atlanta, GA 30374-3904
Phone (225) 302-2253

Other identifiers 1

IdentifierTypeStateIssuer
NP6866MedicaidSC

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
I20210122001720 SC Practitioner - Nurse Practitioner 8325452980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

300 Palmetto Health Pkwy
Suite 200
Columbia, SC 29212-1762
Phone (803) 376-5982

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
214982LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands CurrentSince Dec 4, 2020 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Dec 4, 2020 Accepting new patients

Locations

1301 Taylor St
Ste 1A
Columbia, SC 29201
Phone (803) 254-4591

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

300 Palmetto Health Pkwy
Ste 200
Columbia, SC 29212
Phone (803) 434-4790

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

Interoperability endpoints

  • Direct secure messaging: mniba411168@direct.ghs.myhfn.org

Organizations & group practices 2

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 10

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

NPI Registry JSON

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1801407325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "225-302-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 TAYLOR ST STE 1A",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012946",
            "telephone_number": "803-434-4790",
            "fax_number": "803-434-4799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIBA",
        "first_name": "MARIAGORETTI",
        "middle_name": "LUMNWI",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "214982",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "24275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP6866",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.