PROVIDENCE GROUP PRACTICES II, LLC (NPI# 1184133258) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184133258 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE GROUP PRACTICES II, LLC |
| Other Organization Name | PROVIDENCE CARDIOVASCULAR CONSULTANTS |
| Practice Address |
1330 Haile St Camden SC 29020-3002 |
| Mailing Address |
330 Seven Springs Way Brentwood TN 37027-5098 |
| Practice Telephone | 8034346771 |
| Practice Fax Number | 8034241900 |
| Mailing Telephone | 16159207780 |
| Enumeration Date | 2017-09-21 |
| Last Update Date | 2017-09-25 |
| Authorized Official Name | SARA MILLER (DIRECTOR) |
| Authorized Official Telephone | 6159207514 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
Allopathic & Osteopathic Physicians | ||
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
Allopathic & Osteopathic Physicians | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Providence Cardiovascular Consultants | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396192001 | Providence Group Practices II, LLC | Internal Medicine | 1655 Bernardin Ave, Ste 220, Columbia, SC 29204-2039 | 2016-05-23 |
| Street Address |
1330 HAILE ST |
| City | CAMDEN |
| State | SC |
| Zip Code | 29020-3002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942204912 | Mitchell Todd Alderson | Internal Medicine | 1330 Haile St, Camden, SC 29020-3002 | 2005-06-08 |
| 1053848952 | Carolina Cardiovascular Consultants LLC | Internal Medicine | 1330 Haile St, Camden, SC 29020-3002 | 2017-05-23 |
| 1861940231 | Dana Lorraine Addison | Nurse Practitioner | 1330 Haile St, Camden, SC 29020 | 2016-09-14 |
| 1760763312 | Providence Cardiology LLC | Internal Medicine | 1330 Haile St, Camden, SC 29020-3002 | 2011-09-08 |
| 1184886798 | South Carolina Heart Center Pa | Internal Medicine | 1330 Haile St, Camden, SC 29020-3002 | 2008-06-26 |
| 1710996129 | Shelly C Wilkerson | Nurse Practitioner | 1330 Haile St, Camden, SC 29020-3002 | 2006-08-05 |
| 1629002332 | Paul A Zimmermann | Internal Medicine | 1330 Haile St, Camden, SC 29020-3002 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285252940 | Carolina Orthotics and Prosthetics LLC | Prosthetic/Orthotic Supplier | 708 Lafayette Ave, Ste 4, Camden, SC 29020 | 2020-07-09 |
| 1205493871 | Kershaw County Board of Disabilities and Special Needs | Early Intervention Provider Agency | 1619 Jefferson Davis Highway, Camden, SC 29020 | 2019-05-20 |
| 1831669415 | Jennifer Dawn Colby | Counselor | 709 Mill Street, Camden, SC 29020 | 2018-11-27 |
| 1164990164 | Camden Oral Surgery & Implant Center | Dentist | 207 E. Dekalb St., Camden, SC 29020 | 2018-11-07 |
| 1730684036 | Speech Haus, LLC | Clinic/Center | 1029 Broadstreet, Suite 3, Kershaw, SC 29020 | 2018-03-28 |
| 1811414675 | Audra Rowell Scott | Registered Nurse | Kershaw County Health Department, 1116 Church Street, Camden, SC 29020 | 2017-08-23 |
| 1386173789 | Robert James Mccarthy | Specialist/Technologist | 410 Chewning Street, Camden, SC 29020 | 2017-06-08 |
| 1902357205 | First Physical Therapy LLC | Clinic/Center | 1114 Mill St, Camden, SC 29020 | 2016-10-21 |
| 1831598846 | Estate of William J Biggins | Dentist | 1015 Fair Street, Camden, SC 29020 | 2014-08-14 |
| 1154748424 | Diane Mcdonald | Registered Nurse | 1611 Church St, Camden, SC 29020 | 2014-03-25 |
| Find all providers in zip 29020 | ||||
| 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 |
|---|---|---|---|---|
| 1912912130 | Camden General and Vascular Surgery | Internal Medicine | 1001 Fairlawn Dr, Camden, SC 29020-4525 | 2006-07-29 |
| 1568496271 | Robert G Kiger | Internal Medicine | 1300 Haile St, Camden, SC 29020-3002 | 2006-07-10 |
| 1104858950 | William L Schoolmeester | Internal Medicine | 1045 W Dekalb St, Camden, SC 29020-4162 | 2006-07-06 |
| 1831142207 | Phillip A Koren | Internal Medicine | 3 Cooper Plz Rm 318, Camden, NJ 08103 | 2006-05-18 |
| 1528038817 | Charles Chandler Ashby Jr. | Internal Medicine | 100 Plank Bridge Rd, Camden, NC 27921-2792 | 2006-01-26 |
| 1942204912 | Mitchell Todd Alderson | Internal Medicine | 1330 Haile St, Camden, SC 29020-3002 | 2005-06-08 |
| 1497175707 | Mubashar H Khan | Internal Medicine | 1 Cooper Plz, Dorrance 3rd Floor, Camden, NJ 08103-1461 | 2014-04-25 |
| 1407192289 | Brett Andrew Waldman | Internal Medicine | 1 Cooper Plz, Camden, NJ 08103-1461 | 2012-12-23 |
| 1508111568 | Travante Mcnae Cartwright | Internal Medicine | 1 Cooper Plz, Dorrance 261, Camden, NJ 08103-1461 | 2012-07-16 |
| 1043578974 | Omair Mohammad Javed | Internal Medicine | 401 Haddon Ave, Room 369, Camden, NJ 08103 | 2012-04-28 |
| Find all providers in CAMDEN | ||||
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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.