MATTHEW WALTER JAENICKE (NPI# 1063892008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063892008 |
| Entity Type | Individual |
| Full Name | MATTHEW WALTER JAENICKE |
| Credential | M.D. |
| Practice Address |
1711 Saint Julian Pl Columbia SC 29204-2409 |
| Practice Telephone | 8037790911 |
| Practice Fax Number | 8032562480 |
| Mailing Telephone | 8037790911 |
| Mailing Fax Number | 8032562480 |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2020-10-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
38299 | SC | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | VT | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VT | 0000030538 | 05 |
| Street Address |
1711 SAINT JULIAN PL |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29204-2409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013904838 | Ronald L Collins | Internal Medicine | 1711 Saint Julian Pl, Columbia, SC 29204-2409 | 2005-10-06 |
| 1134665094 | Articularis Healthcare Group Inc. | Internal Medicine | 1711 Saint Julian Pl, Columbia, SC 29204-2409 | 2017-01-16 |
| 1104164219 | Patricia Jones Dailey | Nurse Practitioner | 1711 Saint Julian Pl, Columbia, SC 29204-2409 | 2013-01-24 |
| 1710193008 | Columbia Arthritis Center, Pa | Internal Medicine | 1711 Saint Julian Pl, Columbia, SC 29204-2409 | 2007-05-15 |
| 1962490771 | Kathleen P Flint | Internal Medicine | 1711 Saint Julian Pl, Columbia, SC 29204-2409 | 2005-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992215149 | Ricardo Colon II | Registered Nurse | 3000 Hampton Street, Columbia, SC 29204 | 2017-10-02 |
| 1780113522 | Carla Star Noe | Registered Nurse | Sc Department of Health and Environmental Control, 2100 Bull Street, Collumbia, SC 29204 | 2017-06-06 |
| 1124568514 | Kristy L Thompson | Nurse Practitioner | 1655 Bernardin Ave Ste 240, Columbia, SC 29204 | 2017-03-03 |
| 1982052031 | Harold Eugene Cook Iv | Podiatrist | 1730 St Julian Place, Columbia, SC 29204 | 2016-05-31 |
| 1851748974 | Shaquita Banks | Counselor | 1810 Allen Benedict Ct, A1, Columbia, SC 29204 | 2016-05-18 |
| 1265804835 | Premier Care, LLC | Case Management | 2712 Middleburg Drive, Suite 206, Columbia, SC 29204 | 2015-10-22 |
| 1023492287 | Shamiquia N. Mcpherson | Counselor | 1627 Auburn St., Columbia, SC 29204 | 2015-07-16 |
| 1285028449 | The Columbia Free Medical Clinic, Inc. | Clinic/Center | 1875 Harden Street, Columbia, SC 29204 | 2015-03-26 |
| 1629473459 | Leslie Wilson | Counselor | 2323 Lady Street, Columbia, SC 29204 | 2014-10-22 |
| 1053728683 | Candyce Sutton | Social Worker | 1135 Carter Street, Columbia, SC 29204 | 2014-07-15 |
| Find all providers in zip 29204 | ||||
| Taxonomy Code | 207RR0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Rheumatology |
| An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932209343 | William L Washington | Internal Medicine | 3615 Augusta Dr, Columbia, MO 65203-0990 | 2006-09-25 |
| 1639107097 | Marlyn Lorenzo | Internal Medicine | 6350 Stevens Forest Rd Ste 101, Columbia, MD 21046 | 2006-06-28 |
| 1669416046 | Anthony T Tay | Internal Medicine | 3610 Buttonwood Dr, Suite 200, Columbia, MO 65201-3721 | 2006-06-15 |
| 1215986187 | Darcy D Folzenlogen | Internal Medicine | 1101 Hospital Drive, Columbia, MO 65212-0001 | 2006-05-09 |
| 1013904838 | Ronald L Collins | Internal Medicine | 1711 Saint Julian Pl, Columbia, SC 29204-2409 | 2005-10-06 |
| 1568467546 | Paula Jean Mcmurtry | Internal Medicine | 1705 E Broadway, Suite 220, Columbia, MO 65201 | 2005-06-16 |
| 1386209302 | Nasseri Clinic of Arthritic & Rheumatic Diseases, LLC | Internal Medicine | 5500 Knoll North Dr, Columbia, MD 21045-2370 | 2019-05-06 |
| 1861981508 | Palmetto Health - University of South Carolina Medical Group | Internal Medicine | 2 Medical Park Rd Ste 501, Columbia, SC 29203-6839 | 2018-05-08 |
| 1134665094 | Articularis Healthcare Group Inc. | Internal Medicine | 1711 Saint Julian Pl, Columbia, SC 29204-2409 | 2017-01-16 |
| 1114377207 | Daniel Grant | Internal Medicine | 1 Hospital Dr, Dc043.00, Columbia, MO 65212-1000 | 2016-06-20 |
| Find all providers in COLUMBIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.