Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Haley Tiedemann, PA-C

Individual provider Surgical Physician Assistant · NPI 1568317329

Haley Tiedemann, PA-C is a Physician Assistant in Columbia, South Carolina. Qualified in 2025, 1 year ago. Works from 2 locations. Licensed in South Carolina.

Years since qualifying
1
Licensed in
SC
In the registry since
2026
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

14 Richland Medical Park Dr Ste 310
Columbia, SC 29203-6883
Phone: (803) 434-8450
Fax: (803) 434-0137
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 114 College Ave, Ashland, VA 23005 — (804) 752-8878

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 6264 (SC)
Physician Assistant Taxonomy 363A00000X · Licence 6264 (SC)

Record details

NPI number1568317329
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 26, 2026
Last updated in NPPESMay 28, 2026
Certification dateMay 28, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

Other providers in Columbia