Individual provider Active NPI

Dale Rutledge Hamrick, MD

  • Internal Medicine Physician
  • Columbia, SC
National Provider Identifier
1952370504
Registry record updated Jul 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0185711 Issued in SC
Practice address
124 Spring Valley CT
Columbia, SC 29223-5900
Phone
(803) 422-2985
Fax
(803) 462-0376
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0185711 SC Primary

Addresses

Primary practice location

124 Spring Valley CT
Columbia, SC 29223-5900

Mailing address

PO Box 23656
Columbia, SC 29224-3656
Phone (803) 422-2985

Other identifiers 1

IdentifierTypeStateIssuer
185711MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0185711SCMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278374400000",
    "number": "1952370504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23656",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292243656",
            "telephone_number": "803-422-2985",
            "fax_number": "803-462-0376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 SPRING VALLEY CT",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292235900",
            "telephone_number": "803-422-2985",
            "fax_number": "803-462-0376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMRICK",
        "first_name": "DALE",
        "middle_name": "RUTLEDGE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2010-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "0185711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "185711",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.