NPIMap

Organization Active NPI

Envision Wellness Medical Group

  • Child & Adolescent Psychiatry Physician
  • Columbia, SC
National Provider Identifier
1831511989
Registry record updated Jan 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
22943 Issued in SC
Legal business name
ENVISION WELLNESS MEDICAL GROUP
Practice address
2601 Read St
Suite I-7
Columbia, SC 29204-7861
Phone
(803) 256-0101
Fax
(800) 854-3497
NPI assigned
Jan 8, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2014

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

Authorized official

Name
Ms. Ashley Felder
Title
Office Manager
Phone
(803) 256-0101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0804X 22943 SC Primary

Addresses

Primary practice location

2601 Read St
Suite I-7
Columbia, SC 29204-7861

Mailing address

2601 Read St
Suite I-7
Columbia, SC 29204-7861
Phone (803) 256-0101

Other identifiers 1

IdentifierTypeStateIssuer
229434MedicaidSC

National Provider Directory

National Provider Directory

Locations

2601 Read St
Ste I7
Columbia, SC 29204
Phone (803) 256-0101

NPI Registry JSON

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

{
    "created_epoch": "1389139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389139200000",
    "number": "1831511989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 READ ST",
            "address_2": "SUITE I-7",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292047861",
            "telephone_number": "803-256-0101",
            "fax_number": "800-854-3497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 READ ST",
            "address_2": "SUITE I-7",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292047861",
            "telephone_number": "803-256-0101",
            "fax_number": "800-854-3497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENVISION WELLNESS MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-08",
        "last_updated": "2014-01-08",
        "status": "A",
        "authorized_official_last_name": "FELDER",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "803-256-0101",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "SC",
            "license": "22943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "229434",
            "state": "SC"
        }
    ],
    "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 Jan 8, 2014; 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.