COLONIAL FAMILY PRACTICE, LLC (NPI# 1033640792) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033640792 |
| Entity Type | Organization |
| Organization Name | COLONIAL FAMILY PRACTICE, LLC |
| Practice Address |
1477 Tobias Gadson Blvd Charleston SC 29407 |
| Mailing Address |
325 Broad St Ste 100 Sumter SC 29150-4167 |
| Practice Telephone | 8437667696 |
| Mailing Telephone | 8037735227 |
| Mailing Fax Number | 8037467445 |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2018-05-30 |
| Authorized Official Name | DAVID GLENN WHALEY (PARTNER) |
| Authorized Official Telephone | 8037735227 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912541814 | Colonial Family Practice, LLC | Emergency Medicine | 327 Broad St, Sumter, SC 29150-4152 | 2019-11-04 |
| 1225687338 | Colonial Family Practice, LLC | Internal Medicine | 674 W Liberty St, Sumter, SC 29150-4882 | 2019-09-11 |
| 1366994824 | Colonial Family Practice, LLC | Physician Assistant | 3750 Savannah Hwy Ste I, Johns Island, SC 29455-7909 | 2016-11-01 |
| 1821383068 | Colonial Family Practice, LLC | Clinic/Center | 3044 Highway 17 Byp N Ste B, Mt Pleasant, SC 29466-9315 | 2011-06-16 |
| 1033402599 | Colonial Family Practice, LLC | Physician Assistant | 1124 Little St, Camden, SC 29020-3613 | 2011-05-17 |
| 1144534694 | Colonial Family Practice, LLC | Family Medicine | 3930 Devine St Ste B, Columbia, SC 29205-2804 | 2010-07-27 |
| 1851547640 | Colonial Family Practice, LLC | Counselor | 742 W Liberty St, Sumter, SC 29150-4746 | 2008-08-12 |
| 1518074640 | Colonial Family Practice, LLC | Counselor | 325 Broad St. Ste 100, Sumter, SC 29150-4167 | 2006-08-24 |
| 1598313827 | Colonial Family Practice, LLC | Nurse Practitioner | 26 Wesmark Ct, Sumter, SC 29150-1996 | 2019-08-29 |
| 1689194342 | Colonial Family Practice, LLC | Family Medicine | 1727 Village Park Dr, Orangeburg, SC 29118-2475 | 2017-06-23 |
| Street Address |
1477 TOBIAS GADSON BLVD |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740230028 | Lowcountry Medical Associates | Family Medicine | 1477 Tobias Gadson Blvd, Charleston, SC 29407-4794 | 2006-05-10 |
| 1164964904 | Liberty Doctors LLC | Family Medicine | 1477 Tobias Gadson Blvd, Charleston, SC 29407-4794 | 2016-11-10 |
| 1497206726 | Newton Family Medicine, LLC | Family Medicine | 1477 Tobias Gadson Blvd, Charleston, SC 29407-4794 | 2016-10-21 |
| 1770836363 | Lindsey Diane Kettinger | Nurse Practitioner | 1477 Tobias Gadson Blvd, Charleston, SC 29407-4794 | 2012-10-19 |
| 1891739785 | Edward Marshall Newton | Family Medicine | 1477 Tobias Gadson Blvd, Charleston, SC 29407 | 2006-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437763661 | Charleston Jaw Surgery | Oral & Maxillofacial Surgery | 846 St. Andrews Blvd., Charleston, SC 29407 | 2020-09-04 |
| 1780225128 | New Endeavors Counseling | Social Worker | 1 Carriage Lane Building E Suite 202, Charleston, SC 29407 | 2019-10-07 |
| 1770063158 | Katelyn Campbell | Psychologist | 1 Carriage Ln Ste 102, Charleston, SC 29407 | 2018-08-15 |
| 1164929956 | Anisha Gulati Md LLC | Psychiatry & Neurology | 925 Wappoo Rd., Suite F, Charleston, SC 29407 | 2018-04-09 |
| 1316459753 | David W Richardson | Dentist | 765 St. Andrews Blvd., Charleston, SC 29407 | 2017-10-25 |
| 1457874174 | Meca Mentality LLC | Chiropractor | 1106 St Andrews Blvd Suite A, Charleston, SC 29407 | 2017-07-25 |
| 1639609373 | Carolina Behavioral Specialists, LLC | Behavioral Analyst | 1529 Sam Rittenberg Blvd, Unit 1-b, Charleston, SC 29407 | 2017-06-15 |
| 1467991901 | Bernice Ladson | Registered Nurse | 75o Magnolia Road, Charleston, SC 29407 | 2017-02-16 |
| 1376991257 | Virginia Leigh Thomason | Counselor | 29 Leinbach Dr, Suite D2, Charleston, SC 29407 | 2016-06-01 |
| 1609221001 | Elinor Lee Smith | Counselor | 571 Savannah Hwy, Charleston, SC 29407 | 2016-05-04 |
| Find all providers in zip 29407 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811595499 | Laura Coolidge | Family Medicine | 1528 Seacroft Rd, Charleston, SC 29412-8113 | 2020-10-15 |
| 1356954259 | Relymd Medical Group Wv, Pllc | Family Medicine | 1627 Quarrier St, Charleston, WV 25311-2124 | 2020-08-28 |
| 1922617950 | Fred E Hill | Family Medicine | 1033 Jervey Point Rd, Charleston, SC 29492-8372 | 2020-07-27 |
| 1093375222 | Valley Health Systems, Inc. | Family Medicine | 333 Laidley St Fl 6, Charleston, WV 25301-1614 | 2019-06-19 |
| 1427512201 | Catherine Courtney Slemp | Family Medicine | 350 Capitol St Rm 702, Charleston, WV 25301-1757 | 2019-01-25 |
| 1730677709 | Courtney Uhlar | Family Medicine | 169 Ashley Ave # Msc333, Charleston, SC 29425-9125 | 2018-04-25 |
| 1134617335 | Kelsey Rose Wilson | Family Medicine | 169 Ashley Ave. Room 202, Main Hospital Msc 333, Charleston, SC 29425-9125 | 2018-04-24 |
| 1659869816 | Anthony James Baglio | Family Medicine | 169 Ashley Avenue, Room 202 Main Hospital, Msc 333, Charleston, SC 29425 | 2018-04-24 |
| 1396252219 | Lisa Ann Oshaughnessy Turnure | Family Medicine | 3 Sawgrass Rd Apt I6, Charleston, SC 29412-2579 | 2017-12-30 |
| 1720467525 | Sasha M. Perez | Family Medicine | 3030 Ashley Town Center Dr Ste 102a, Charleston, SC 29414 | 2015-05-26 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 29407 |
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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.