BROAD RIVER PHYSICIANS GROUP, LLC (NPI# 1235659103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235659103 |
| Entity Type | Organization |
| Organization Name | BROAD RIVER PHYSICIANS GROUP, LLC |
| Practice Address |
120 Gateway Corporate Blvd Columbia SC 29203-9611 |
| Mailing Address |
Po Box 21801 Belfast ME 04915-4115 |
| Practice Telephone | 8038654500 |
| Mailing Telephone | 7708745400 |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2020-02-05 |
| Authorized Official Name | KIM H LARSEN (DIRECTOR OF CREDENTIALING) |
| Authorized Official Telephone | 7708745400 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154841021 | Broad River Physicians Group, LLC | Emergency Medicine | 2435 Forest Dr, Columbia, SC 29204-2026 | 2017-06-22 |
| Street Address |
120 GATEWAY CORPORATE BLVD |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29203-9611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215932405 | Providence Hospital Northeast Transitional Care Unit | Skilled Nursing Facility | 120 Gateway Corporate Blvd, Columbia, SC 29203-9802 | 2005-06-15 |
| 1366819138 | Ashley Templeton | Physical Therapist | 120 Gateway Corporate Blvd, Columbia, SC 29203-9611 | 2015-08-27 |
| 1942614607 | Megan Wilderotter Ackerson | Physician Assistant | 120 Gateway Corporate Blvd, Emergency Department, Columbia, SC 29203-9611 | 2014-06-19 |
| 1811310576 | Providence Orthopedic Group, LLC | Orthopaedic Surgery | 120 Gateway Corporate Blvd, Columbia, SC 29203-9611 | 2014-01-30 |
| 1588086672 | Charles Driggers | Physician Assistant | 120 Gateway Corporate Blvd, Columbia, SC 29203-9611 | 2014-01-09 |
| 1972860344 | Jamie Edens Gilligan | Registered Nurse | 120 Gateway Corporate Blvd, Columbia, SC 29203-9611 | 2012-04-23 |
| 1639443948 | Jamie Lea Disharoon | Nurse Anesthetist, Certified Registered | 120 Gateway Corporate Blvd, Columbia, SC 29203-9611 | 2012-03-05 |
| 1740484658 | Augustine Health Group, LLC | Internal Medicine | 120 Gateway Corporate Blvd, Columbia, SC 29203-9611 | 2007-06-13 |
| 1255497202 | Michael T Hayes | Emergency Medicine | 120 Gateway Corporate Blvd, Columbia, SC 29203-9802 | 2006-12-27 |
| 1912097056 | Roy Hampton Smith | Nurse Practitioner | 120 Gateway Corporate Blvd, Emergency Department, Columbia, SC 29203-9611 | 2006-10-12 |
| 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 | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053972349 | Alanna Diamond | Emergency Medicine | One Hospital Drive Emergency Medicine M652 Dc029.10, Columbia, MO 65212-0001 | 2019-06-26 |
| 1942867767 | Robert Lee Stanley | Emergency Medicine | Emergency Medicine Dept, 14 Medical Park, Ste 350, Columbia, SC 29203 | 2019-05-28 |
| 1013573146 | Michael Habhab | Emergency Medicine | 1 Hospital Dr Emergency Medicine M562 Dc029.10, Columbia, MO 65212-0001 | 2019-05-14 |
| 1790349355 | Romie Sarand Barnes | Emergency Medicine | Emergency Medicine Administration, 14 Medical Park, Ste 350, Columbia, SC 29203 | 2019-04-29 |
| 1043730716 | Ian James Becker | Emergency Medicine | 1 Hospital Dr # Dc029.10, Columbia, MO 65212-1000 | 2017-06-23 |
| 1487002523 | Christopher Adam Waranch | Emergency Medicine | University of Missouri Columbia, Department of Emergency Medicine, Columbia, MO 65212-0001 | 2016-05-31 |
| 1639542202 | Doctors Care Sc, Pa | Emergency Medicine | 1538 Main St, Columbia, SC 29201-2808 | 2015-11-04 |
| 1548649627 | Brian Edward Snyder | Emergency Medicine | 14 Medical Park, Ste 350 Emergency Medicine Department, Columbia, SC 29203 | 2015-05-22 |
| 1447664974 | Christopher Daniel Kohls | Emergency Medicine | 14 Medical Park Ste 350, Emergency Medicine Dept, Columbia, SC 29203 | 2014-06-12 |
| 1407268113 | James Fallin | Emergency Medicine | 14 Medical Park, Ste 350, Emergency Medicine Dept, Columbia, SC 29203 | 2014-05-29 |
| 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.