DR. CLYDE H FLANAGAN JR. (NPI# 1093776569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093776569 |
| Entity Type | Individual |
| Full Name | DR. CLYDE H FLANAGAN JR. |
| Credential | M.D. |
| Practice Address |
15 Medical Park Rd Suite 103 Columbia SC 29203-8003 |
| Mailing Address |
15 Medical Park Rd Suite 300 Columbia SC 29203-8003 |
| Practice Telephone | 8034344300 |
| Practice Fax Number | 8034344277 |
| Mailing Telephone | 8034344300 |
| Mailing Fax Number | 8034344277 |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2008-12-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
14326 | SC | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
14326 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 143268 | 05 |
| Street Address |
15 MEDICAL PARK RD SUITE 103 |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29203-8003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821065921 | Lisa Henderson Bryant | Psychiatry & Neurology | 15 Medical Park Rd, Suite 300, Columbia, SC 29203-8003 | 2006-03-07 |
| 1104322429 | Rachel Metcalfe | Psychiatry & Neurology | 15 Medical Park Rd, Suite 141, Columbia, SC 29201 | 2018-04-04 |
| 1639105232 | Shilpa Srinivasan | Psychiatry & Neurology | 15 Medical Park Rd, Suite 141, Columbia, SC 29203-8003 | 2006-06-24 |
| 1558324798 | Yolanda Vanessa Edwards | Psychologist | 15 Medical Park Rd, Suite 103, Columbia, SC 29203-8003 | 2006-04-10 |
| 1316900855 | Amanda W Slater | Nurse Practitioner | 15 Medical Park Rd, Suite 300, Columbia, SC 29203-8003 | 2006-04-07 |
| 1003878547 | Richard Lesesne Frierson | Psychiatry & Neurology | 15 Medical Park Rd, Suite 301, Columbia, SC 29203-8003 | 2006-04-03 |
| 1053372805 | William L Brannon | Psychiatry & Neurology | 15 Medical Park Rd, Suite 104b, Columbia, SC 29203-8003 | 2006-03-31 |
| 1902867526 | Leslie Kaye Burke | Psychologist | 15 Medical Park Rd, Suite 103, Columbia, SC 29203-8003 | 2006-03-31 |
| 1083675615 | Nioaka Nicole Campbell | Psychiatry & Neurology | 15 Medical Park Rd, Suite 103, Columbia, SC 29203-8003 | 2006-03-31 |
| 1306807573 | Allison Foster Defelice | Psychologist | 15 Medical Park Rd, Suite 103, Columbia, SC 29203-8003 | 2006-03-29 |
| 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 | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043832157 | Envision Wellness Medical Group LLC | Psychiatry & Neurology | 4100 N Main St Ste 101, Columbia, SC 29203-5800 | 2020-05-12 |
| 1548664964 | Melody Ann Boling | Psychiatry & Neurology | 1 Hospital Dr # Dc067.00, Department of Psychiatry, Columbia, MO 65212-1000 | 2014-10-14 |
| 1548502362 | Dina Marie Sztein | Psychiatry & Neurology | 9841 Broken Land Pkwy Ste 211, Columbia, MD 21046 | 2013-03-19 |
| 1568736247 | David Downie Iv, M.d.,p.a. | Psychiatry & Neurology | 1327 Richland Street, Columbia, SC 29201 | 2012-02-28 |
| 1447522800 | Life Strategies LLC | Psychiatry & Neurology | 2855 Pruitt Dr, Columbia, SC 29204-3645 | 2012-02-01 |
| 1699938217 | Anita Bajaj | Psychiatry & Neurology | 10015 Old Columbia Rd # L26d, Columbia, MD 21046-1703 | 2008-07-03 |
| 1306024930 | Kimberly C Walker | Psychiatry & Neurology | 10630 Little Patuxent Pkwy Ste 313, Columbia, MD 21044-6216 | 2008-02-06 |
| 1043308356 | Herbert Randolph Spencer | Psychiatry & Neurology | 1800 Colonial Drive, Columbia, SC 29201 | 2006-10-11 |
| 1891883005 | Elizabeth Hubbard Jeffords | Psychiatry & Neurology | 3612 Landmark Dr Ste B, Columbia, SC 29204-4039 | 2006-10-11 |
| 1134231723 | Judith Victoria Ovalle Abuabara | Psychiatry & Neurology | 106 Corporate Lake Dr, Columbia, MO 65203-7170 | 2006-08-31 |
| Find all providers in COLUMBIA | ||||
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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.