NPIMap

Individual provider Active NPI

Dwayne Randolph Alleyne, ACNPC

  • Acute Care Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1962644393
Registry record updated May 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
3853 Issued in SC
Practice address
6439 Garners Ferry Rd
Columbia, SC 29209-1638
Phone
(803) 776-4000
NPI assigned
Mar 31, 2009
Last updated
May 27, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 3853 SC Primary

Addresses

Primary practice location

6439 Garners Ferry Rd
Columbia, SC 29209-1638

Mailing address

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

Other practice location 1

14 Richland Medical Park Dr Ste 320
Columbia, SC 29203-6896
Phone (803) 434-6771

Other identifiers 1

IdentifierTypeStateIssuer
NP6786MedicaidSC

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
I20200423002267 SC Practitioner - Nurse Practitioner 5991135451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Carolina School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

Taylor at Marion St
Columbia, SC 29220-0001
Phone (803) 296-5579

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3853SCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands Current Accepting new patients
Palmetto Health - University of South Carolina Medical Group CurrentSince Mar 21, 2020 Accepting new patients
Prisma Health Medical Group-Midlands Current Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Mar 21, 2020 Accepting new patients

Locations

14 Richland Medical Park Dr
Ste 320
Columbia, SC 29203
Phone (803) 434-1663

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

Taylor At Marion St
Columbia, SC 29220
Phone (803) 296-3097

115 N Sumter St
Ste 110
Sumter, SC 29150
Phone (803) 774-5249

Interoperability endpoints

  • Direct secure messaging: dalleyne412313@direct.ghs.myhfn.org

Organizations & group practices 4

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 7

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

NPI Registry JSON

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

{
    "created_epoch": "1238457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1962644393",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6439 GARNERS FERRY RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292091638",
            "telephone_number": "803-776-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Richland Medical Park Dr Ste 320",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292036896",
            "country_code": "US",
            "telephone_number": "803-434-6771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEYNE",
        "first_name": "DWAYNE",
        "middle_name": "RANDOLPH",
        "name_prefix": "Mr.",
        "credential": "ACNPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-31",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "SC",
            "license": "3853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP6786",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.