Individual provider Active NPI

Robert A Vande Stouwe, MD PH D

  • Allergy & Immunology Physician
  • Columbia, SC
National Provider Identifier
1952417800
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
11671 Issued in SC
Practice address
One Richland Medical Park
Suite 200 Carolina Allergy and Asthma Consultants
Columbia, SC 29203
Phone
(803) 765-9233
Fax
(803) 779-0344
NPI assigned
Aug 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 11671 SC Primary

Addresses

Primary practice location

One Richland Medical Park
Suite 200 Carolina Allergy and Asthma Consultants
Columbia, SC 29203

Mailing address

One Richland Medical Park
Suite 200 Carolina Allergy and Asthma Consultants
Columbia, SC 29203
Phone (803) 765-9233

Other identifiers 1

IdentifierTypeStateIssuer
116715MedicaidSC

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
I20100429000301 SC Practitioner - Allergy/Immunology 2769519453 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Columbia University College of Physicians and Surgeons, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Allergy and Asthma ConsultantsGroup PAC ID 3173650876, 5 clinicians

Practice addresses (Care Compare)

1 Richland Medical Park Dr
Columbia, SC 29203-6830

One Richland Medical Park
Suite 200
Columbia, SC 29203-6830

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11671SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Allergy & Asthma Consultants Allergy & Immunology CurrentSince Feb 17, 1997 Accepting new patients

Locations

1 Richland Medical Park Dr
Ste 200
Columbia, SC 29203
Phone (803) 765-9233

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1952417800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE RICHLAND MEDICAL PARK",
            "address_2": "SUITE 200 CAROLINA ALLERGY AND ASTHMA CONSULTANTS",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "803-765-9233",
            "fax_number": "803-779-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE RICHLAND MEDICAL PARK",
            "address_2": "SUITE 200 CAROLINA ALLERGY AND ASTHMA CONSULTANTS",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "803-765-9233",
            "fax_number": "803-779-0344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDE STOUWE",
        "first_name": "ROBERT",
        "middle_name": "A",
        "credential": "MD PH D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "SC",
            "license": "11671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116715",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.