PROVIDENCE PHYSICIAN PRACTICES LLC (NPI# 1770943631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770943631 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE PHYSICIAN PRACTICES LLC |
| Other Organization Name | CAROLINA CARDIOVASCULAR ASSOCIATES |
| Practice Address |
114 Gateway Corporate Blvd Ste 425 Columbia SC 29203-9740 |
| Practice Telephone | 8038654780 |
| Mailing Telephone | 8038654780 |
| Enumeration Date | 2016-03-04 |
| Last Update Date | 2017-02-22 |
| Authorized Official Name | JESS N JUDY (PRESIDENT) |
| Authorized Official Telephone | 6159207000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| CAROLINA CARDIOVASCULAR ASSOCIATES | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285253336 | Providence Physician Practices LLC | Orthopaedic Surgery | 114 Gateway Corporate Blvd Ste 220a, Columbia, SC 29203-9785 | 2020-04-09 |
| 1659921740 | Providence Physician Practices LLC | Optometrist | 216 E Marion St, Kershaw, SC 29067-1442 | 2019-09-19 |
| 1558710376 | Providence Physician Practices LLC | Family Medicine | 7936 Broad River Rd, Irmo, SC 29063-2355 | 2016-06-13 |
| 1689034548 | Providence Physician Practices LLC | Plastic Surgery | 1655 Bernardin Ave, Ste 110, Columbia, SC 29204-2039 | 2016-03-04 |
| 1770941742 | Providence Physician Practices LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2750 Laurel St, Ste 305, Columbia, SC 29204-2038 | 2016-02-05 |
| 1033577002 | Providence Physician Practices LLC | Family Medicine | 2435 Forest Dr, Columbia, SC 29204-2026 | 2016-02-05 |
| 1902264971 | Providence Physician Practices LLC | Physiological Laboratory | 2750 Laurel St, Ste 104, Columbia, SC 29204-2038 | 2016-02-05 |
| 1083072045 | Providence Physician Practices LLC | Nurse Anesthetist, Certified Registered | 2435 Forest Dr, Columbia, SC 29204-2026 | 2016-02-05 |
| 1790143766 | Providence Physician Practices LLC | Internal Medicine | 1655 Bernardin Ave, Ste 350, Columbia, SC 29204-2039 | 2016-02-05 |
| 1689030595 | Providence Physician Practices LLC | Internal Medicine | 2001 Laurel St, Ste 300, Columbia, SC 29204-1018 | 2016-01-07 |
| Street Address |
114 GATEWAY CORPORATE BLVD STE 425 |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29203-9740 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689644221 | Eric Steven Spotts | Obstetrics & Gynecology | 114 Gateway Corporate Blvd, Suite 350, Columbia, SC 29203-9740 | 2006-01-25 |
| 1093253254 | Midlands Orthopaedics and Neurosurgery, Pa | Orthopaedic Surgery | 114 Gateway Corporate Blvd, Suite 110, Columbia, SC 29203-9740 | 2017-02-08 |
| 1366980591 | Midlands Orthopaedics and Neurosurgery, Pa | Durable Medical Equipment & Medical Supplies | 114 Gateway Corporate Blvd, Suite 110, Columbia, SC 29203-9740 | 2017-02-08 |
| 1033657275 | Midlands Orthopaedics and Neurosurgery, Pa | Neurological Surgery | 114 Gateway Corporate Blvd, Suite 110, Columbia, SC 29203-9740 | 2017-02-08 |
| 1811448517 | Arcis Healthcare | Durable Medical Equipment & Medical Supplies | 114 Gateway Corporate Blvd, Suite 110, Columbia, SC 29203-9740 | 2016-10-18 |
| 1437521259 | Arcis Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 114 Gateway Corporate Blvd, Suite 110, Columbia, SC 29203-9740 | 2015-10-21 |
| 1447632989 | Lori Uhrig | Physical Therapist | 114 Gateway Corporate Blvd, Columbia, SC 29203-9740 | 2015-06-21 |
| 1265814701 | Gretchen Zimmerman Tarrance | Occupational Therapist | 114 Gateway Corporate Blvd, Columbia, SC 29203-9740 | 2015-06-21 |
| 1437531944 | Lyle Oamil | Physical Therapist | 114 Gateway Corporate Blvd, Columbia, SC 29203-9740 | 2015-06-19 |
| 1790196293 | Providence Cardiology LLC | Internal Medicine | 114 Gateway Corporate Blvd, Suite 300, Columbia, SC 29203-9740 | 2014-05-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475284 | Matthew Leon Brigmon | Surgery | 2 Richland Medical Park, Suite 300, Columbia, SC 29203 | 2020-10-23 |
| 1730706839 | John James Gannon | Family Medicine | Prisma Health Medical Group Family Medicine, 3209 Colonial Drive, Columbia, SC 29203 | 2020-07-06 |
| 1790302362 | Klariz Teves Tucker | Internal Medicine | Internal Medcine Center, 1801 Sunset Drive, Columbia, SC 29203 | 2020-06-30 |
| 1811514482 | Esther Ruth Swan | Psychiatry & Neurology | Prisma Health General Psychiatry Center, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-30 |
| 1447877014 | Jordan Kaitlyn Merrels | Psychiatry & Neurology | Prisma Health Medical Group General Psychiatry, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-30 |
| 1306463187 | Jessica Leigh Watson | Psychiatry & Neurology | Prisma Health General Psychiatry, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-29 |
| 1053938852 | Garrison Glenn Rice | Family Medicine | Prisma Health Medical Group Family Medical Center, 3209 Colonial Drive, Columbia, SC 29203 | 2020-06-29 |
| 1053938977 | Rachel Ellen Harper | Obstetrics & Gynecology | The Womens Center, 1801 Sunset Drive, Columbia, SC 29203 | 2020-06-26 |
| 1609493592 | Elizabeth Marie Kern | Orthopaedic Surgery | Prisma Health Medical Group Orthopedic Center, 2 Medical Park, Ste 105, Columbia, SC 29203 | 2020-06-26 |
| 1891312799 | Kathryn Victoria Steverson | Psychiatry & Neurology | Prisma Health Medical Group Psychiatry Center, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-26 |
| Find all providers in zip 29203 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| 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. |
| 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 | ||||
Please comment or provide details below to improve the information on PROVIDENCE PHYSICIAN PRACTICES LLC.
| 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.