Active NPI
Dwight Davis Ballard, MSW
- Clinical Social Worker
- Columbia, SC
National Provider Identifier
1992968630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 8585
- Practice address
- 3201 Trenholm Road
Columbia, SC 29204-3371 - Phone
- (803) 782-1421
- NPI assigned
- Jul 2, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 8585 | SC | Primary |
Addresses
Primary practice location
3201 Trenholm Road
Columbia, SC 29204-3371
Mailing address
1357 Goffman Road
Eastover, SC 29044-8728
Phone (803) 782-1421
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8585 | SC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214956800000",
"number": "1992968630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1357 GOFFMAN ROAD",
"city": "EASTOVER",
"state": "SC",
"postal_code": "290448728",
"telephone_number": "803-782-1421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3201 TRENHOLM ROAD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292043371",
"telephone_number": "803-782-1421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALLARD",
"first_name": "DWIGHT",
"middle_name": "DAVIS",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-02",
"last_updated": "2008-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "SC",
"license": "8585",
"primary": true
}
],
"identifiers": [],
"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 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.