PROVIDENCE GROUP PRACTICES LLC


Address: 2001 Laurel St, Columbia, SC 29204-1018
Phone: 8032543278

PROVIDENCE GROUP PRACTICES LLC (NPI# 1598123549) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1598123549
Entity Type Organization
Organization Name PROVIDENCE GROUP PRACTICES LLC
Other Organization Name SOUTH CAROLINA HEART CENTER
Practice Address 2001 Laurel St
Columbia
SC 29204-1018
Practice Telephone 8032543278
Mailing Telephone 8032543278
Enumeration Date 2016-02-05
Last Update Date 2017-02-22
Authorized Official Name JESS JUDY (PRESIDENT)
Authorized Official Telephone 6159207000
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207RC0001X Internal Medicine
Specialization: Clinical Cardiac Electrophysiology
Allopathic & Osteopathic Physicians
N 207RI0011X Internal Medicine
Specialization: Interventional Cardiology
Allopathic & Osteopathic Physicians
N 207UN0901X Nuclear Medicine
Specialization: Nuclear Cardiology
Allopathic & Osteopathic Physicians
Y 207RC0000X Internal Medicine
Specialization: Cardiovascular Disease
Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
SOUTH CAROLINA HEART CENTER Doing Business As Name - Organization

Office Location

Street Address 2001 LAUREL ST
City COLUMBIA
State SC
Zip Code 29204-1018

Providers in the same location

NPI Name Taxonomy Address Enumeration
1265434088 Melissa Rowland Nurse Practitioner 2001 Laurel St, Columbia, SC 29204-1018 2005-08-11
1174180699 Erin Jaynes Belk Registered Nurse 2001 Laurel St, Columbia, SC 29204-1018 2019-05-20
1689030595 Providence Physician Practices LLC Internal Medicine 2001 Laurel St, Ste 300, Columbia, SC 29204-1018 2016-01-07
1265716039 Providence Cardiology LLC Internal Medicine 2001 Laurel St, Columbia, SC 29204-1018 2011-09-28
1518248459 Providence Cardiology Internal Medicine 2001 Laurel St, Columbia, SC 29204-1018 2011-09-06
1679737720 South Carolina Heart Center Pa Internal Medicine 2001 Laurel St, Columbia, SC 29204-1018 2008-07-17
1255517728 Jamie D Cunningham Nurse Practitioner 2001 Laurel St, Columbia, SC 29204-1018 2008-01-15
1003822693 Brenda Ligon Physician Assistant 2001 Laurel St, Columbia, SC 29204-1018 2006-08-01
1750396388 Rebecca Fullam Nurse Practitioner 2001 Laurel St, Columbia, SC 29204-1018 2006-07-30
1386673879 Mark L Orlandini Internal Medicine 2001 Laurel St, Columbia, SC 29204-1018 2006-06-30
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207RC0000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Cardiovascular Disease

Taxonomy Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1376050534 Khoury Cardiology, Pa Internal Medicine 151 Saluda Ave, Columbia, SC 29205-3080 2018-01-09
1669919247 Hari Gnanasekeram, PC Internal Medicine 207 Zeigler St, Columbia, SC 29217-0001 2017-01-20
1033514120 Palmetto Health Internal Medicine 6 Richland Medical Park Dr, Suite 2100, Columbia, SC 29203-6864 2014-10-31
1639516636 Namit Rohant Internal Medicine 2 Medical Park Rd Ste 402, Columbia, SC 29203-6839 2013-05-30
1720358112 William Fox Internal Medicine 11837 Winterlong Way, Columbia, MD 21044-4412 2012-01-03
1134418874 Daniel A Kim Internal Medicine 10710 Charter Dr Ste 400, Columbia, MD 21044 2011-04-04
1730321035 Columbia Cardiology, LLC Internal Medicine 130 Corporate Blvd, Columbia, SC 29204 2009-04-01
1447415211 Anil Purohit Internal Medicine 6 Richland Medical Park Drive Suite 2100, Columbia, SC 29203 2008-07-22
1679740195 Warren F Holland Internal Medicine 3628 Cassina Cir, Columbia, SC 29205-1854 2008-05-14
1386826824 Sirisha Donekal Internal Medicine 11055 Little Patuxent Pkwy Ste 205, Columbia, MD 21044 2007-11-27
Find all providers in COLUMBIA

Competitor

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City COLUMBIA
Zip Code 29204

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Dataset Information

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.

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