Individual provider Active NPI

Jeffrey Donald Raynor, MD

  • Forensic Psychiatry Physician
  • Columbia, SC
National Provider Identifier
1841409760
Registry record updated Nov 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic Psychiatry PhysicianTaxonomy code 2084F0202X
License
29848 Issued in SC
Practice address
11 Richland Medical Park Dr
Columbia, SC 29203-6863
Phone
(803) 434-4800
Fax
(803) 434-4878
NPI assigned
May 21, 2007
Last updated
Nov 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychiatry Physician 2084F0202X 29848 SC Primary
Psychiatry Physician 2084P0800X 29848 SC
Hospitalist Physician 208M00000X 29848 SC

Addresses

Primary practice location

11 Richland Medical Park Dr
Columbia, SC 29203-6863

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

Taylor At Marion
Columbia, SC 29220-0001
Phone (803) 296-5579

Other identifiers 1

IdentifierTypeStateIssuer
298485MedicaidSC

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
I20071011000378 SC Practitioner - Psychiatry 9234225996 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of South Carolina School of Medicine, 2002
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

220 Faison Dr
Columbia, SC 29203-3210
Phone (803) 898-8415

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29848SCMDForensic Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Aug 27, 2019 Accepting new patients
Prisma Health Medical Group-Midlands Psychiatry Current Accepting new patients
South Carolina Dept of Mental Health Accounting Office Psychiatry Current Accepting new patients
South Carolina Dept of Mental Health Accounting Office Psychiatry CurrentSince Aug 27, 2019 Accepting new patients
Prisma Health Medical Group-Midlands Hospitalist CurrentSince Aug 21, 2016 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Aug 21, 2016 Accepting new patients

Locations

100 Palmetto Health Pkwy
Ste 104
Columbia, SC 29212
Phone (803) 434-5668

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

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

220 Faison Dr
Columbia, SC 29203
Phone (803) 898-1662

2414 Bull St
Columbia, SC 29201
Phone (803) 898-2461

3 Richland Medical Park Dr
Ste 510
Columbia, SC 29203
Phone (803) 296-2726

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

115 N Sumter St
Ste 110
Sumter, SC 29150
Phone (803) 774-5249

129 N Washington St
Sumter, SC 29150
Phone (803) 774-1752

Interoperability endpoints

  • Direct secure messaging: jraynor502905@direct.ghs.myhfn.org

Organizations & group practices 6

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668124800000",
    "number": "1841409760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 RICHLAND MEDICAL PARK DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036863",
            "telephone_number": "803-434-4800",
            "fax_number": "803-434-4878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Taylor At Marion",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292200001",
            "country_code": "US",
            "telephone_number": "803-296-5579",
            "fax_number": "803-296-5578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAYNOR",
        "first_name": "JEFFREY",
        "middle_name": "DONALD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "SC",
            "license": "29848",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "29848",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "SC",
            "license": "29848",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "298485",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.