Individual provider Active NPI

Dianna D Ravenell, MD

  • Obstetrics & Gynecology Physician
  • Columbia, SC
National Provider Identifier
1891789624
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
28087 Issued in SC
Practice address
9 Richland Medical Park Dr Ste 620
Columbia, SC 29203-6845
Phone
(803) 779-6776
Fax
(803) 779-7346
NPI assigned
Sep 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 28087 SC Primary

Addresses

Primary practice location

9 Richland Medical Park Dr Ste 620
Columbia, SC 29203-6845

Mailing address

PO Box 743904
Atlanta, GA 30374-3904
Phone (803) 296-7320

Other practice location 1

1228 Harden St
Columbia, SC 29204-1800
Phone (803) 744-0540

Other identifiers 1

IdentifierTypeStateIssuer
280877MedicaidSC

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
I20050928000903 SC Practitioner - Obstetrics/Gynecology 6507891595 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28087SCMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg South Carolina PC Obstetrics & Gynecology CurrentSince Jun 9, 2017 Accepting new patients
Kraemer Womens Care, LLC Obstetrics & Gynecology CurrentSince Apr 29, 2019 Accepting new patients
Spartanburg Medical Center Obstetrics & Gynecology CurrentSince Sep 13, 2017 Accepting new patients
Spartanburg Medical Center Current Accepting new patients
Sandhills OBGYN Associates, P.a. Obstetrics & Gynecology CurrentSince Jan 29, 2019 Accepting new patients
Spartanburg Medical Center CurrentSince Sep 13, 2017 Accepting new patients
Uwh of the Carolinas, PLLC Obstetrics & Gynecology CurrentSince Aug 1, 2021 Accepting new patients
Prisma Health-Midlands Past Accepting new patients
Prisma Health-Midlands Past Accepting new patients
Eau Claire Cooperative Health Center, Inc PastSince Jan 13, 2013 Accepting new patients

Locations

1027 Physicians Dr
Ste 110
Charleston, SC 29414
Phone (843) 740-6700

1333 Taylor St
Ste 3J
Columbia, SC 29201
Phone (803) 296-7350

1330 Taylor St
Columbia, SC 29201
Phone (803) 296-5137

1333 Taylor St
Ste 2D
Columbia, SC 29201
Phone (803) 254-1300

700 Gervais St
Ste 125
Columbia, SC 29201

9330 Medical Plaza Dr
North Charleston, SC 29406
Phone (843) 554-6366

101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915

295 Midland Pkwy
Summerville, SC 29485
Phone (843) 554-6366

501 Robertson Blvd
Walterboro, SC 29488
Phone (843) 549-2000

3221 Sunset Blvd
Ste A
West Columbia, SC 29169
Phone (803) 798-7660

Interoperability endpoints

  • Direct secure messaging: dravenell508264@direct.musc.edu
  • FHIR API: https://api.platform.athenahealth.com/10781/brand/1/csg/1/fhir/r4
  • Direct secure messaging: dravenell413548@direct.ghs.myhfn.org
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 10

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": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1891789624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-296-7320",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 RICHLAND MEDICAL PARK DR STE 620",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036845",
            "telephone_number": "803-779-6776",
            "fax_number": "803-779-7346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1228 Harden St",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292041800",
            "country_code": "US",
            "telephone_number": "803-744-0540",
            "fax_number": "803-744-0542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAVENELL",
        "first_name": "DIANNA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-08",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "28087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280877",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.