COLONIAL FAMILY PRACTICE, LLC (NPI# 1467999326) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467999326 |
| Entity Type | Organization |
| Organization Name | COLONIAL FAMILY PRACTICE, LLC |
| Other Organization Name | SANTEE COOPER URGENT CARE |
| Practice Address |
1013 Professional Ct Suite A Manning SC 29102-2827 |
| Mailing Address |
325 Broad St Ste 100 Sumter SC 29150-4167 |
| Practice Telephone | 8034337425 |
| Practice Fax Number | 8034180202 |
| Mailing Telephone | 8037735227 |
| Mailing Fax Number | 8037467445 |
| Enumeration Date | 2017-01-30 |
| Last Update Date | 2019-11-08 |
| Authorized Official Name | MRS. STEPHANIE KNIGHT DISHER (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 8037735227 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
Allopathic & Osteopathic Physicians | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Santee Cooper 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 |
| 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 |
1013 PROFESSIONAL CT SUITE A |
| City | MANNING |
| State | SC |
| Zip Code | 29102-2827 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073581047 | Gina G Wilson | Nurse Practitioner | 1013 Professional Ct, Manning, SC 29102-2827 | 2006-03-08 |
| 1508302308 | Colonial Family Practice, LLC | Family Medicine | 1013 Professional Ct, Suite C, Manning, SC 29102-2827 | 2017-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720546138 | Dental Wellness Center of Manning, LLC | Clinic/Center | 1988 Paxille Hwy, Ste 613-01, Manning, SC 29102 | 2019-03-05 |
| 1982148433 | Allison Elaine Saran | Registered Nurse | Mcleod Women's Health, 50 East Hospital Street Suite 4a, Manning, SC 29102 | 2016-12-16 |
| 1629529698 | Clarendon Behavioral Health | Health Maintenance Organization | 14 N. Church Street, Manning, SC 29102 | 2016-10-14 |
| 1396158200 | Monica Ploetzke | Obstetrics & Gynecology | 50 E Hospital St Ste 4a, Manning, SC 29102 | 2014-06-09 |
| 1336567239 | Marian Moody | Registered Nurse | 110 Boyce Street, Dhec Clarendon County Health Dept, Manning, SC 29102 | 2014-03-29 |
| 1700212420 | Southern Lakes Therapy,llc | Physical Therapist | 297 W Boyce St, Manning, SC 29102 | 2013-09-26 |
| 1902190473 | Professional Care of Manning, LLC | In Home Supportive Care | 220 West Boyce St, Manning, SC 29102 | 2011-06-02 |
| 1275789810 | Vital Care Ambulance Service, LLC. | Ambulance | 3662 Greeleyville Hwy, Manning, SC 29102 | 2008-08-14 |
| 1831384015 | Ramona J Howard | Registered Nurse | 10 E. Hospital Street, Hospitalist Department, Manning, SC 29102 | 2007-09-11 |
| 1619098670 | H P Bozard Dds Pa | Dentist | 17 East Hospital Street, Manning, SC 29102 | 2007-04-03 |
| Find all providers in zip 29102 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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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.