CAPITOL ER GROUP LLC (NPI# 1003996539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003996539 |
| Entity Type | Organization |
| Organization Name | CAPITOL ER GROUP LLC |
| Practice Address |
2435 Forest Drive Columbia SC 29204 |
| Mailing Address |
Po Box 12350 Westminster CA 92685-2350 |
| Practice Telephone | 8032565300 |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DAVID C WINN (FINANCE OFFICE MEMBER) |
| Authorized Official Telephone | 8006577103 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP4106 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366547101 | Capitol Er Group LLC | Emergency Medicine | 120 Gateway Corporate Blvd, Columbia, SC 29203-9802 | 2006-09-14 |
| Street Address |
2435 FOREST DRIVE |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194796607 | Sisters of Charity Providence Hospitals | Nurse Anesthetist, Certified Registered | 2435 Forest Drive, Columbia, SC 29204 | 2006-02-01 |
| 1023394152 | Michael James Blew | Hospitalist | 2435 Forest Drive, Columbia, SC 29204 | 2011-11-03 |
| 1851539696 | Karen Clarke Wiggins | Registered Nurse | 2435 Forest Drive, Providence Hospital, Columbia, SC 29204 | 2009-02-02 |
| 1174720684 | Ann S. Hall | Nurse Anesthetist, Certified Registered | 2435 Forest Drive, Columbia, SC 29204-2026 | 2007-06-28 |
| 1477673465 | Anthony Chi Zamcho | Internal Medicine | 2435 Forest Drive, Columbia, SC 29204 | 2007-03-31 |
| 1942331756 | Lawrence E Draper | Nurse Anesthetist, Certified Registered | 2435 Forest Drive, Columbia, SC 29204 | 2007-03-07 |
| 1275637571 | Michael R Zeno | Emergency Medicine | 2435 Forest Drive, Columbia, SC 29204-2026 | 2006-09-08 |
| 1700831930 | Susan H. Beriault-williams | Nurse Anesthetist, Certified Registered | 2435 Forest Drive, Columbia, SC 29204 | 2006-05-24 |
| 1639132582 | Elizabeth R. Huggins | Nurse Anesthetist, Certified Registered | 2435 Forest Drive, Columbia, SC 29204 | 2006-04-11 |
| 1225098379 | Virginia Rose Kearse | Nurse Anesthetist, Certified Registered | 2435 Forest Drive, Columbia, SC 29204 | 2006-03-24 |
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| 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 | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053972349 | Alanna Diamond | Emergency Medicine | One Hospital Drive Emergency Medicine M652 Dc029.10, Columbia, MO 65212-0001 | 2019-06-26 |
| 1942867767 | Robert Lee Stanley | Emergency Medicine | Emergency Medicine Dept, 14 Medical Park, Ste 350, Columbia, SC 29203 | 2019-05-28 |
| 1013573146 | Michael Habhab | Emergency Medicine | 1 Hospital Dr Emergency Medicine M562 Dc029.10, Columbia, MO 65212-0001 | 2019-05-14 |
| 1790349355 | Romie Sarand Barnes | Emergency Medicine | Emergency Medicine Administration, 14 Medical Park, Ste 350, Columbia, SC 29203 | 2019-04-29 |
| 1043730716 | Ian James Becker | Emergency Medicine | 1 Hospital Dr # Dc029.10, Columbia, MO 65212-1000 | 2017-06-23 |
| 1487002523 | Christopher Adam Waranch | Emergency Medicine | University of Missouri Columbia, Department of Emergency Medicine, Columbia, MO 65212-0001 | 2016-05-31 |
| 1639542202 | Doctors Care Sc, Pa | Emergency Medicine | 1538 Main St, Columbia, SC 29201-2808 | 2015-11-04 |
| 1548649627 | Brian Edward Snyder | Emergency Medicine | 14 Medical Park, Ste 350 Emergency Medicine Department, Columbia, SC 29203 | 2015-05-22 |
| 1447664974 | Christopher Daniel Kohls | Emergency Medicine | 14 Medical Park Ste 350, Emergency Medicine Dept, Columbia, SC 29203 | 2014-06-12 |
| 1407268113 | James Fallin | Emergency Medicine | 14 Medical Park, Ste 350, Emergency Medicine Dept, Columbia, SC 29203 | 2014-05-29 |
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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.