NPIMap

Individual provider Active NPI

Marcono Raymond Hines Jr., MD

  • Nephrology Physician
  • Columbia, SC
National Provider Identifier
1932375631
Registry record updated Aug 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
34269 Issued in SC
Practice address
121 Park Central Dr
Suite 200
Columbia, SC 29203-6476
Phone
(803) 252-9907
Fax
(803) 252-9906
NPI assigned
May 2, 2008
Last updated
Aug 30, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 34269 SC Primary

Addresses

Primary practice location

121 Park Central Dr
Suite 200
Columbia, SC 29203-6476

Mailing address

121 Park Central Dr
Suite 200
Columbia, SC 29203-6476
Phone (803) 252-9907

Other identifiers 1

IdentifierTypeStateIssuer
342695MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120730000803 SC Practitioner - NephrologyPractitioner - Internal Medicine 4385800762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Duke University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

121 Park Central Dr
Suite 200
Columbia, SC 29203-6476
Phone (803) 726-2399

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Nephrology Associates PA CurrentSince Jul 1, 2012 Accepting new patients
Columbia Nephrology Associates PA Nephrology CurrentSince Jul 1, 2012 Accepting new patients

Locations

121 Park Central Dr
Ste 200
Columbia, SC 29203
Phone (803) 252-9907

Interoperability endpoints

  • Direct secure messaging: marconohinesjr@cna.allscriptsdirect.net
  • Direct secure messaging: mhines380578@direct.musc.edu

Organizations & group practices 2

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.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1209686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504051200000",
    "number": "1932375631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 PARK CENTRAL DR",
            "address_2": "SUITE 200",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036476",
            "telephone_number": "803-252-9907",
            "fax_number": "803-252-9906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 PARK CENTRAL DR",
            "address_2": "SUITE 200",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036476",
            "telephone_number": "803-252-9907",
            "fax_number": "803-252-9906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINES",
        "first_name": "MARCONO",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-02",
        "last_updated": "2017-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "SC",
            "license": "34269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "342695",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.