AUGUSTINE HEALTH GROUP, LLC (NPI# 1750401451) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750401451 |
| Entity Type | Organization |
| Organization Name | AUGUSTINE HEALTH GROUP, LLC |
| Other Organization Name | PROVIDENCE NORTHEAST FAMILY CARE AT LAKE CAROLINA |
| Practice Address |
300 Long Pointe Ln Suite 130 Columbia SC 29229-7543 |
| Mailing Address |
Po Box 60496 Charlotte NC 28260-0496 |
| Practice Telephone | 8034627193 |
| Practice Fax Number | 8034627163 |
| Mailing Telephone | 8034627193 |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2008-03-07 |
| Authorized Official Name | JEREMY W WHITAKER (MANAGER) |
| Authorized Official Telephone | 8038654798 |
| Authorized Official Credential | CPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP4545 | 05 |
| Other Name | Type Code |
|---|---|
| Providence Northeast Family Care at Lake Carolina | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790114197 | Augustine Health Group, LLC | Family Medicine | 110 Dutchman Blvd, Irmo, SC 29063-8330 | 2013-11-06 |
| 1093966400 | Augustine Health Group, LLC | Internal Medicine | 2701 Middleburg Drive, Columbia, SC 29204 | 2008-10-03 |
| 1578830279 | Augustine Health Group, LLC | General Practice | 2351 Augusta Hwy, Lexington, SC 29072-2213 | 2011-11-23 |
| 1639463771 | Augustine Health Group, LLC | Family Medicine | 190 Knox Abbott Dr, Suite 3-c, Cayce, SC 29033-4348 | 2011-06-07 |
| 1871887919 | Augustine Health Group, LLC | Internal Medicine | 2601 Laurel St, Suite 230, Columbia, SC 29204-2033 | 2011-06-07 |
| 1144523051 | Augustine Health Group, LLC | Internal Medicine | 114 Gateway Corporate Blvd, Suite 330, Columbia, SC 29203-9740 | 2010-12-15 |
| 1881903938 | Augustine Health Group, LLC | Specialist | 108 Palmetto Park Blvd, Lexington, SC 29072-7968 | 2010-10-06 |
| 1780998161 | Augustine Health Group, LLC | Internal Medicine | 2601 Laurel St, Suite 120, Columbia, SC 29204-2033 | 2010-07-28 |
| 1639375199 | Augustine Health Group, LLC | Psychiatry & Neurology | 114 Gateway Corporate Blvd, Suite 425, Columbia, SC 29203-9740 | 2007-06-22 |
| 1548466006 | Augustine Health Group, LLC | Internal Medicine | 2435 Forest Dr, Columbia, SC 29204-2026 | 2007-06-22 |
| Street Address |
300 LONG POINTE LN SUITE 130 |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29229-7543 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194332619 | Candid South Carolina, P.C. | Dentist | 136-4 Forum Drive #a20, Columbia, SC 29229 | 2020-09-29 |
| 1275166761 | Isis Marie Pearson | Behavior Technician | 4611 Hardscrabble Rd, #239, Columbia, SC 29229 | 2020-02-13 |
| 1083254338 | Lintiya Mccleary | Behavior Technician | 1048 Wildewood Center Dr, Columbia, SC 29229 | 2020-01-14 |
| 1538702873 | Genuine Care LLC | Home Health Aide | 112 Denby Cir, Columbia, SC 29229 | 2019-10-18 |
| 1588218028 | John Calvin Thorne Iv | Pharmacist | 175 Forum Drive, Columbia, SC 29229 | 2019-08-01 |
| 1801303839 | Eye Associates of Columbia Inc | Clinic/Center | 470-5 Town Center Pl, Lenscrafters, Columbia, SC 29229 | 2017-12-28 |
| 1508385469 | Palmetto Community Group | Counselor | 402 Nautique Circle, Columbia, SC 29229 | 2017-09-12 |
| 1245754472 | Fernandez Interpreter & Translator Solutions | Interpreter | 140 Rivendale Drive, Columbia, SC 29229 | 2017-07-30 |
| 1770935744 | Yasmine Gamil Gabr | Family Medicine | 103 Summit Centre Drive, Columbia, SC 29229 | 2016-07-01 |
| 1386095164 | Mack's Loving Care | Home Health | 55 Crooked Creek Place, Columbia, SC 29229 | 2016-06-23 |
| Find all providers in zip 29229 | ||||
| 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 |
|---|---|---|---|---|
| 1447868005 | Brittany Mechelle Waterworth | Family Medicine | 3700 I 70 Dr Se Ste 106, Columbia, MO 65201-6587 | 2020-07-20 |
| 1730706839 | John James Gannon | Family Medicine | Prisma Health Medical Group Family Medicine, 3209 Colonial Drive, Columbia, SC 29203 | 2020-07-06 |
| 1053938852 | Garrison Glenn Rice | Family Medicine | Prisma Health Medical Group Family Medical Center, 3209 Colonial Drive, Columbia, SC 29203 | 2020-06-29 |
| 1457977563 | Jenny Tatiana Gonzalez Guzman | Family Medicine | Prisma Health Family Medical Center, 3209 Colonial Drive, Columbia, SC 29203 | 2020-06-24 |
| 1942825500 | Jarvis Jamal Johnson | Family Medicine | Prisma Health Family Medicine Center, 3209 Colonial Drive, Columbia, SC 29203 | 2020-06-10 |
| 1386268183 | Nicolas Anthony Limogiannis | Family Medicine | Prisma Health Medical Group Family Medicine Center, 3209 Colonial Drive, Columbia, SC 29203 | 2020-06-08 |
| 1730724220 | Luci Lee Redman Cassella | Family Medicine | 8900 Columbia 100 Parway Suite G, Columbia, MD 21045 | 2019-11-08 |
| 1275177420 | Palmetto Primary Care Physicians | Family Medicine | 1415 Blanding St Ste 2, Columbia, SC 29201-2922 | 2019-10-31 |
| 1558919852 | Synergos Medical, LLC | Family Medicine | 1703 Oak Cliff Pl, Columbia, MO 65203-4719 | 2019-08-29 |
| 1972156982 | Maury Regional Medical Group, Inc | Family Medicine | 2478 Nashville Hwy Ste A, Columbia, TN 38401-0634 | 2019-07-18 |
| 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.