NPIMap

Individual provider Active NPI

Phillip Andrews Reath, PA-C

  • Medical Physician Assistant
  • Columbia, SC
National Provider Identifier
1821466202
Registry record updated Mar 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2389 Issued in SC
Practice address
8 Richland Medical Park Dr
Suite 100
Columbia, SC 29203
Phone
(803) 434-3800
Fax
(803) 744-2759
NPI assigned
Sep 2, 2015
Last updated
Mar 14, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2389 SC Primary

Addresses

Primary practice location

8 Richland Medical Park Dr
Suite 100
Columbia, SC 29203

Mailing address

15 Exchange Dr
Lugoff, SC 29078-9198
Phone (803) 424-2207

Other identifiers 2

IdentifierTypeStateIssuer
2929PAMedicaidSC
SC79579988OtherSCMEDICARE

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
I20160503001176 SC Practitioner - Physician Assistant 1153620711 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Lincoln Memorial University Medical Department, 2015
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)

11 Richland Medical Park Dr
Columbia, SC 29203-6863
Phone (803) 434-4506

2 Medical Park Rd
Suite 506
Columbia, SC 29203-6876
Phone (803) 540-1000

7 Richland Medical Park Dr
Columbia, SC 29203-6863

8 Richland Medical Park Dr
Columbia, SC 29203-8004
Phone (803) 765-0871

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2389SCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health-Midlands CurrentSince Feb 9, 2016 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Mar 1, 2020 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Mar 1, 2020 Accepting new patients
Prisma Health Medical Group-Midlands Past Accepting new patients

Locations

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

8 Richland Medical Park Dr
Ste 100
Columbia, SC 29203
Phone (803) 434-2762

8 Richland Medical Park Dr
Ste 400
Columbia, SC 29203
Phone (803) 296-7305

9 Richland Medical Park Dr
Ste 450
Columbia, SC 29203
Phone (803) 434-8800

Interoperability endpoints

  • Direct secure messaging: preath383871@direct.ghs.myhfn.org

Organizations & group practices 5

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 7

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": "1441152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552521600000",
    "number": "1821466202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 EXCHANGE DR",
            "city": "LUGOFF",
            "state": "SC",
            "postal_code": "290789198",
            "telephone_number": "803-424-2207",
            "fax_number": "803-408-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 RICHLAND MEDICAL PARK DR",
            "address_2": "SUITE 100",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "803-434-3800",
            "fax_number": "803-744-2759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REATH",
        "first_name": "PHILLIP",
        "middle_name": "ANDREWS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-02",
        "last_updated": "2019-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "2389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2929PA",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "SC79579988",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.