Basic Information
| Provider Information | |||||||||
| NPI: | 1811929037 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ONEILL | ||||||||
| FirstName: | CARA | ||||||||
| MiddleName: | MP | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | PARSONS | ||||||||
| OtherFirstName: | CARA | ||||||||
| OtherMiddleName: | MARIE | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | NINE MED PARK | ||||||||
| Address2: | SUITE 200A UNIV PEDIATRICS | ||||||||
| City: | COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8034347950 | ||||||||
| FaxNumber: | 8034343855 | ||||||||
| Practice Location | |||||||||
| Address1: | FOURTEEN MEDICAL PARK | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8034347950 | ||||||||
| FaxNumber: | 8034343855 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2006 | ||||||||
| LastUpdateDate: | 05/21/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 23911 | SC | N | Other Service Providers | Specialist | 208000000X | 23911 | SC | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | $$$$$$$$$ | 01 | SC | SSN | OTHER | GP0219 | 05 | SC | MEDICAID | 23911 | 01 | SC | SC MEDICAL LIC # | OTHER |