Individual provider Active NPI

Dewitt McIntyre Coleman Jr., M. D.

  • Allergy & Immunology Physician
  • West Columbia, SC
National Provider Identifier
1821088261
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
27671 Issued in SC
Practice address
103 Midlands CT
West Columbia, SC 29169-3456
Phone
(803) 794-3581
Fax
(803) 791-7286
NPI assigned
Oct 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 27671 SC Primary

Addresses

Primary practice location

103 Midlands CT
West Columbia, SC 29169-3456

Mailing address

PO Box 603725
Charlotte, NC 28260-3725
Phone (828) 575-2625

Other identifiers 2

IdentifierTypeStateIssuer
AA08816874OtherSCMEDICARE PTAN
276711MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050623000540 SC Practitioner - Allergy/Immunology 6204820269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Medical University of South Carolina College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allergy Partners PLLCGroup PAC ID 7113822420, 144 clinicians

Practice addresses (Care Compare)

103 Midlands CT
West Columbia, SC 29169-3456
Phone (803) 794-3581

Hospital & facility affiliations

  • Lexington Medical Center Hospital, West Columbia, SC, CCN 420073

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
27671SCMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy Partners, PLLC Allergy & Immunology CurrentSince Aug 1, 2005 Accepting new patients
Allergy Partners, PLLC Allergy & Immunology Current Accepting new patients
NPI 1508468638 Allergy & Immunology CurrentSince Aug 1, 2005 Accepting new patients
SCB Inc Past Accepting new patients
Allergy Partners, PLLC Allergy & Immunology Past Accepting new patients

Locations

1001 Fairlawn Dr
#B
Camden, SC 29020
Phone (803) 794-3581

103 Midlands Ct
West Columbia, SC 29169
Phone (803) 794-3581

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1821088261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603725",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603725",
            "telephone_number": "828-575-2625",
            "fax_number": "828-350-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 MIDLANDS CT",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693456",
            "telephone_number": "803-794-3581",
            "fax_number": "803-791-7286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "DEWITT",
        "middle_name": "MCINTYRE",
        "name_suffix": "Jr.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "SC",
            "license": "27671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "AA08816874",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276711",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

Verify at the official NPI Registry.