COLONIAL FAMILY PRACTICE, LLC (NPI# 1508302308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508302308 |
| Entity Type | Organization |
| Organization Name | COLONIAL FAMILY PRACTICE, LLC |
| Other Organization Name | PRIMARY CARE AT SANTEE COOPER |
| Practice Address |
1013 Professional Ct Suite C Manning SC 29102-2827 |
| Practice Telephone | 8034337444 |
| Practice Fax Number | 8034180202 |
| Mailing Telephone | 8034337444 |
| Mailing Fax Number | 8034180202 |
| Enumeration Date | 2017-01-17 |
| Last Update Date | 2017-01-17 |
| Authorized Official Name | BRAD MCINTOSH (OFFICE MANAGER) |
| Authorized Official Telephone | 8034337444 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Primary Care at Santee Cooper | 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 C |
| 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 |
| 1467999326 | Colonial Family Practice, LLC | Emergency Medicine | 1013 Professional Ct, Suite A, Manning, SC 29102-2827 | 2017-01-30 |
| 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 | 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 |
|---|---|---|---|---|
| 1356458061 | William C. Aldrich | Family Medicine | 1036 Professional Ct, Manning, SC 29102-2827 | 2006-08-25 |
| 1538188495 | Clarendon Memorial Hospital | Family Medicine | 22 Bozard Street, Manning, SC 29102 | 2006-07-19 |
| 1326089590 | Clarendon Memorial Hospital | Family Medicine | 50 Hospital St, Suite 4, Manning, SC 29102 | 2006-06-09 |
| 1003878455 | Edward C. Keith Jr. | Family Medicine | 15 E Hospital St, Manning, SC 29102-3152 | 2006-04-03 |
| 1730166430 | Lisa E Heichberger | Family Medicine | 22 Bozard St, Manning, SC 29102-2935 | 2005-12-23 |
| 1659367241 | Manning Family Healthcare Clinic PC | Family Medicine | 321 Center St, Manning, IA 51455-1020 | 2005-09-20 |
| 1710973391 | Philip L Myer | Family Medicine | 1550 6th Street, Manning, IA 51455-1004 | 2005-09-20 |
| 1558366039 | Robert S Eagerton Jr. | Family Medicine | 200 E Hospital St, Manning, SC 29102-3160 | 2005-06-20 |
| 1790247252 | Ohio Valley Physicians Inc | Family Medicine | 14 N Church St, Manning, SC 29102-3502 | 2019-04-03 |
| 1689194060 | Clarendon Health and Wellness Center | Family Medicine | 107 Sunset Dr, Manning, SC 29102-2904 | 2017-06-26 |
| Find all providers in MANNING | ||||
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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.