Jan Presberg MD LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

22802 Issued in SC

Legal business name

JAN PRESBERG MD LLC

Practice address

1904 Sunset Blvd
Suite D
West Columbia, SC 29169-5932

Phone

(803) 791-1485

Fax

(803) 939-9378

NPI assigned

May 3, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jan Presberg, M.D.NPI 1386796795

Title

Medical Doctor and Owner

Phone

(803) 791-1485

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jan Presberg, M.D.

  • Child & Adolescent Psychiatry Physician
  • West Columbia, SC
  • NPI 1386796795
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350864000000",
    "number": "1841412178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 SUNSET BLVD",
            "address_2": "SUITE D",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291695932",
            "telephone_number": "803-791-1485",
            "fax_number": "803-939-9378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 SUNSET BLVD",
            "address_2": "SUITE D",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291695932",
            "telephone_number": "803-791-1485",
            "fax_number": "803-939-9378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAN PRESBERG MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2012-10-22",
        "status": "A",
        "authorized_official_last_name": "PRESBERG",
        "authorized_official_first_name": "JAN",
        "authorized_official_title_or_position": "MEDICAL DOCTOR AND OWNER",
        "authorized_official_telephone_number": "803-791-1485",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "22802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "228024",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aakash Jain
• Edward Joseph Jakubs II, MD
• Holly J Jakubs, CRNA
• Lillian Michelle James
• Erica N Jamison, OT
• Kelly Bryce Jansen, OTR/L
• Sarah Elizabeth Jardin Ray, DMD
• Jay M Markowitz MD & Associates
• Deandra Jefferson
• Delvina Gladys Jeffries, CERTIFIED HAIR LOSS

• Psychiatry Physician in West Columbia, SC
• Providers in West Columbia, SC by specialty
• Psychiatry Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.