COLONIAL FAMILY PRACTICE, LLC (NPI# 1144534694) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144534694 |
| Entity Type | Organization |
| Organization Name | COLONIAL FAMILY PRACTICE, LLC |
| Other Organization Name | COLONIAL FAMILY PRACTICE URGENT CARE |
| Practice Address |
3930 Devine St Ste B Columbia SC 29205-2804 |
| Mailing Address |
325 Broad St Suite 100 Sumter SC 29150-4167 |
| Practice Telephone | 8037735227 |
| Practice Fax Number | 8037745400 |
| Mailing Telephone | 8037735227 |
| Mailing Fax Number | 8037745400 |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2018-05-30 |
| Authorized Official Name | MRS. STEPHANIE K DISHER (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 8037735227 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 76892 | SC | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Colonial Family Practice Urgent Care | Doing Business As Name - Organization |
| 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 |
| 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 |
| 1033640792 | Colonial Family Practice, LLC | Family Medicine | 1477 Tobias Gadson Blvd, Charleston, SC 29407 | 2017-03-24 |
| Street Address |
3930 DEVINE ST STE B |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29205-2804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104462241 | New Life Home Care LLC | In Home Supportive Care | 4423 Ste. D, Devine Street, Columbia, SC 29205 | 2019-11-25 |
| 1689144222 | Jessica M Jarman LLC | Counselor | 610 Holly St., Columbia, SC 29205 | 2018-11-27 |
| 1073083648 | Christopher James Troyer | Psychologist | 2805 Millwood Ave., Columbia, SC 29205 | 2018-11-27 |
| 1891277505 | Daniel Long | Pharmacist | 630 Kilbourne Road, Columbia, SC 29205 | 2018-08-30 |
| 1699126136 | Steven Matthew Ferrufino | Counselor | 417 S Edisto Ave, Columbia, SC 29205 | 2016-06-27 |
| 1619351863 | Deangela Lenore Delaney | Nurse Practitioner | 2739 Laurel Street, Columbia, SC 29205 | 2015-07-17 |
| 1548677131 | Maegan Elizabeth Dean | Pharmacist | 2708 Rosewood Drive, Columbia, SC 29205 | 2014-07-16 |
| 1144561465 | Abby Habicht | Speech-Language Pathologist | 705 Maple St., H 102, Columbia, SC 29205 | 2013-03-12 |
| 1750630562 | Pamela B. Robertson | Pharmacist | 3312 Devine Street, Columbia, SC 29205 | 2012-09-07 |
| 1609124023 | Kristen Anne Tice | Dietitian, Registered | 1029 Deerwood Street, Columbia, SC 29205 | 2012-08-15 |
| Find all providers in zip 29205 | ||||
| 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 |
|---|---|---|---|---|
| 1447868005 | Brittany Mechelle Waterworth | Family Medicine | 3700 I 70 Dr Se Ste 106, Columbia, MO 65201-6587 | 2020-07-20 |
| 1730706839 | John James Gannon | Family Medicine | Prisma Health Medical Group Family Medicine, 3209 Colonial Drive, Columbia, SC 29203 | 2020-07-06 |
| 1053938852 | Garrison Glenn Rice | Family Medicine | Prisma Health Medical Group Family Medical Center, 3209 Colonial Drive, Columbia, SC 29203 | 2020-06-29 |
| 1457977563 | Jenny Tatiana Gonzalez Guzman | Family Medicine | Prisma Health Family Medical Center, 3209 Colonial Drive, Columbia, SC 29203 | 2020-06-24 |
| 1942825500 | Jarvis Jamal Johnson | Family Medicine | Prisma Health Family Medicine Center, 3209 Colonial Drive, Columbia, SC 29203 | 2020-06-10 |
| 1386268183 | Nicolas Anthony Limogiannis | Family Medicine | Prisma Health Medical Group Family Medicine Center, 3209 Colonial Drive, Columbia, SC 29203 | 2020-06-08 |
| 1730724220 | Luci Lee Redman Cassella | Family Medicine | 8900 Columbia 100 Parway Suite G, Columbia, MD 21045 | 2019-11-08 |
| 1275177420 | Palmetto Primary Care Physicians | Family Medicine | 1415 Blanding St Ste 2, Columbia, SC 29201-2922 | 2019-10-31 |
| 1558919852 | Synergos Medical, LLC | Family Medicine | 1703 Oak Cliff Pl, Columbia, MO 65203-4719 | 2019-08-29 |
| 1972156982 | Maury Regional Medical Group, Inc | Family Medicine | 2478 Nashville Hwy Ste A, Columbia, TN 38401-0634 | 2019-07-18 |
| 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.