COLONIAL FAMILY PRACTICE, LLC (NPI# 1164833026) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164833026 |
| Entity Type | Organization |
| Organization Name | COLONIAL FAMILY PRACTICE, LLC |
| Other Organization Name | CFP SPECIALTIES |
| Practice Address |
385 W Wesmark Blvd Sumter SC 29150 |
| Mailing Address |
325 Broad St Suite 100 Sumter SC 29150-4167 |
| Practice Telephone | 8037735227 |
| Practice Fax Number | 8037539121 |
| Mailing Telephone | 8037735227 |
| Mailing Fax Number | 8037539121 |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2020-02-12 |
| 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 |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 25247 | SC | Allopathic & Osteopathic Physicians |
| N | 207QS1201X |
Family Medicine Specialization: Sleep Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | 33281 | SC | Allopathic & Osteopathic Physicians |
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 247100000X | Radiologic Technologist | 00-8178 | SC | Technologists, Technicians & Other Technical Service Providers |
| N | 261QS1200X |
Clinic/Center Specialization: Sleep Disorder Diagnostic |
25247 | SC | Ambulatory Health Care Facilities |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
2006 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
33821 | SC | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| CFP Specialties | Other Name - Individual/Organization |
| Colonial Neurology and Sleep Lab | 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 |
| 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 |
385 W WESMARK BLVD |
| City | SUMTER |
| State | SC |
| Zip Code | 29150 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598922130 | John Kenneth Baker | Psychiatry & Neurology | 385 W Wesmark Blvd, Sumter, SC 29150-1987 | 2008-05-21 |
| 1871044826 | Kala Young | Physician Assistant | 385 W Wesmark Blvd, Sumter, SC 29150-1987 | 2016-10-14 |
| 1538489117 | Lillian June Wilson | Technician/Technologist | 385 W Wesmark Blvd, Sumter, SC 29150-1987 | 2010-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174152557 | Stacey Delene Mcconico | Adult Companion | 201 East Liberty Street, Sumter, SC 29150 | 2020-04-07 |
| 1780227942 | Add Light Home Care LLC | In Home Supportive Care | 698-s Bultman Dr, Suite C-8, Sumter, SC 29150 | 2019-10-21 |
| 1770044075 | Kimberly A Weeks | Technician, Other | 5 E Liberty Street, Sumter, SC 29150 | 2019-03-28 |
| 1689155103 | Chrishena E Craig | Social Worker | 801 N. Pike West, Sumter, SC 29150 | 2018-08-23 |
| 1093200735 | Michael B Coseo | Dietitian, Registered | 1278 N. Lafayette Drive, Sumter, SC 29150 | 2018-06-26 |
| 1790287258 | Keever Murdaugh | Physical Therapy Assistant | 1018 North Guignard Drive, Sumter, SC 29150 | 2018-03-01 |
| 1679094643 | James D Pearson | Emergency Medical Technician, Basic | 9b Willow Drive, Sumter, SC 29150 | 2017-06-29 |
| 1245771781 | Shanekia Littles | In Home Supportive Care | 251 Rast St Unit D-1, Sumter, SC 29150 | 2017-03-16 |
| 1326590415 | Believe In Faith Home Care | In Home Supportive Care | 410 W Liberty St Suite 102, Sumter, SC 29150 | 2016-10-25 |
| 1912368457 | Urology Clinic, Inc. | Urology | 1285 Wilson Hall Rd, Sumter, SC 29150 | 2016-03-11 |
| Find all providers in zip 29150 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598922130 | John Kenneth Baker | Psychiatry & Neurology | 385 W Wesmark Blvd, Sumter, SC 29150-1987 | 2008-05-21 |
| 1487624862 | Mobile Diagnostics, LLC | Psychiatry & Neurology | 312 Broad Street, Sumter, SC 29150 | 2006-01-26 |
| 1801055173 | South East Neurology, LLC | Psychiatry & Neurology | 308 W Wesmark Blvd, Sumter, SC 29150-1977 | 2008-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693039 | Ppcp Specialty Physicians, LLC | Psychiatry & Neurology | 5500 Front St Ste 230, Summerville, SC 29486-7735 | 2020-09-14 |
| 1093323875 | Carolina Neurology & Neuroimaging LLC | Psychiatry & Neurology | 111 Shire Dr, Anderson, SC 29621-3675 | 2020-07-17 |
| 1891312799 | Kathryn Victoria Steverson | Psychiatry & Neurology | Prisma Health Medical Group Psychiatry Center, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-26 |
| 1336764240 | Jal Ankeeth Ved | Psychiatry & Neurology | Prisma Health Medical Group Neurology, 8 Medical Park, Ste 420, Columbia, SC 29203 | 2020-06-16 |
| 1427608819 | Ppcp Specialty Physicians, LLC | Psychiatry & Neurology | 9221 University Blvd Ste 2d, North Charleston, SC 29406-9148 | 2019-09-17 |
| 1801454830 | Mark Joshua Rosenberg | Psychiatry & Neurology | 96 Jonathan Lucas St Csb 301, Msc 606, Charleston, SC 29425-0001 | 2019-06-04 |
| 1851955413 | David Alan Lockwood Jr. | Psychiatry & Neurology | Neurology Patient Care, 8 Medical Park, Ste 420, Columbia, SC 29203 | 2019-04-29 |
| 1164995700 | Amy Elizabeth Gallozzi | Psychiatry & Neurology | 531 Tributary Dr, Fort Lawn, SC 29714-8625 | 2019-01-07 |
| 1952896789 | Lauren Crawford | Psychiatry & Neurology | 96 Jonathan Street Suite 301, Charleston, SC 29425-0001 | 2018-06-25 |
| 1831610989 | Christopher Bruck Zust | Psychiatry & Neurology | 8 Medical Park Ste 420, Neurology Clinic, Columbia, SC 29203 | 2017-06-29 |
| Find all providers with the same taxonomy | ||||
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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.