Individual provider Active NPI

Rainier James Braganza Martin, DO

  • Student in an Organized Health Care Education/Training Program
  • West Columbia, SC
National Provider Identifier
1861288573
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2720 Sunset Blvd
West Columbia, SC 29169-4810
Phone
(803) 791-2000
NPI assigned
Apr 18, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X SC Primary

Addresses

Primary practice location

2720 Sunset Blvd
West Columbia, SC 29169-4810

Mailing address

9191 Florence Ave Unit 5
Downey, CA 90240-3450
Phone (562) 334-7123

Other practice location 1

9191 Florence Ave Unit 5
Downey, CA 90240-3450
Phone (562) 334-7123

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
I20251023003651 SC Order and Referring Only - Family PracticePractitioner - Family Practice 9436647104

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington County Health Services District Inc Current Accepting new patients

Locations

2720 Sunset Blvd
West Columbia, SC 29169
Phone (803) 791-2480

Interoperability endpoints

  • Direct secure messaging: rmartin190547@direct.lexmed.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1744934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1861288573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9191 FLORENCE AVE UNIT 5",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902403450",
            "telephone_number": "562-334-7123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 SUNSET BLVD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694810",
            "telephone_number": "803-791-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9191 Florence Ave Unit 5",
            "address_purpose": "LOCATION",
            "city": "Downey",
            "state": "CA",
            "postal_code": "902403450",
            "country_code": "US",
            "telephone_number": "562-334-7123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "RAINIER JAMES",
        "middle_name": "BRAGANZA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-18",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

Verify at the official NPI Registry.