NPIMap

Individual provider Active NPI

Tameka Stacey-Ann Funny, D.O.

  • Infectious Disease Physician
  • Columbia, SC
National Provider Identifier
1972794394
Registry record updated Mar 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
39903 Issued in SC
Practice address
1333 Taylor St
Suite 6F
Columbia, SC 29201-2923
Phone
(803) 296-3273
Fax
(803) 296-7061
NPI assigned
Aug 9, 2007
Last updated
Mar 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 39903 SC Primary
Infectious Disease Physician 207RI0200X OS11222 FL

Addresses

Primary practice location

1333 Taylor St
Suite 6F
Columbia, SC 29201-2923

Mailing address

PO Box 743904
Atlanta, GA 30374-3904
Phone (803) 296-7303

Other practice location 1

1333 Taylor St
Suite 6F
Columbia, SC 29201-2923
Phone (803) 296-3273

Other identifiers 3

IdentifierTypeStateIssuer
004076000MedicaidFL
14FV3OtherFLBCBSFL
399037MedicaidSC

Other names 1

  • Tameka Stacey-Ann Simpson Former name

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
I20170316000301 SC Practitioner - Infectious DiseasePractitioner - Internal Medicine 4587835277 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 2006
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)

1333 Taylor St
Suite 6F
Columbia, SC 29201-2953
Phone (803) 296-3273

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands CurrentSince Jun 21, 2017 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Jun 21, 2017 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

1333 Taylor St
Ste 6F
Columbia, SC 29201
Phone (803) 296-3273

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

3 Richland Medical Park Dr
Ste 510
Columbia, SC 29203
Phone (803) 296-2726

3555 Harden Street Ext
Ste 300
Columbia, SC 29203
Phone (803) 434-6411

Interoperability endpoints

  • Direct secure messaging: tfunny379211@direct.ghs.myhfn.org

Organizations & group practices 3

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 12

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": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521158400000",
    "number": "1972794394",
    "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": "803-296-7303",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 TAYLOR ST",
            "address_2": "SUITE 6F",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012923",
            "telephone_number": "803-296-3273",
            "fax_number": "803-296-7061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1333 Taylor St",
            "address_2": "Suite 6F",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292012923",
            "country_code": "US",
            "telephone_number": "803-296-3273",
            "fax_number": "803-296-7061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUNNY",
        "first_name": "TAMEKA",
        "middle_name": "STACEY-ANN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-09",
        "last_updated": "2018-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "SC",
            "license": "39903",
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "OS11222",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004076000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "14FV3",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "399037",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMEKA",
            "last_name": "SIMPSON",
            "middle_name": "STACEY-ANN",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.