PROVIDENCE PHYSICIAN PRACTICES LLC (NPI# 1790143766) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790143766 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE PHYSICIAN PRACTICES LLC |
| Other Organization Name | MIDLANDS PULMONARY, CRITICAL CARE & SLEEP MEDICINE |
| Practice Address |
1655 Bernardin Ave Ste 350 Columbia SC 29204-2039 |
| Mailing Address |
114 Gateway Corporate Blvd Ste 425 Columbia SC 29203-9740 |
| Practice Telephone | 8032537575 |
| Practice Fax Number | 8032537571 |
| Mailing Telephone | 8038654780 |
| Enumeration Date | 2016-02-05 |
| Last Update Date | 2017-02-22 |
| Authorized Official Name | JESS JUDY (PRESIDENT) |
| Authorized Official Telephone | 6159207000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RS0012X |
Internal Medicine Specialization: Sleep Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| MIDLANDS PULMONARY, CRITICAL CARE & SLEEP MEDICINE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285253336 | Providence Physician Practices LLC | Orthopaedic Surgery | 114 Gateway Corporate Blvd Ste 220a, Columbia, SC 29203-9785 | 2020-04-09 |
| 1659921740 | Providence Physician Practices LLC | Optometrist | 216 E Marion St, Kershaw, SC 29067-1442 | 2019-09-19 |
| 1558710376 | Providence Physician Practices LLC | Family Medicine | 7936 Broad River Rd, Irmo, SC 29063-2355 | 2016-06-13 |
| 1689034548 | Providence Physician Practices LLC | Plastic Surgery | 1655 Bernardin Ave, Ste 110, Columbia, SC 29204-2039 | 2016-03-04 |
| 1770943631 | Providence Physician Practices LLC | Internal Medicine | 114 Gateway Corporate Blvd, Ste 425, Columbia, SC 29203-9740 | 2016-03-04 |
| 1770941742 | Providence Physician Practices LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2750 Laurel St, Ste 305, Columbia, SC 29204-2038 | 2016-02-05 |
| 1033577002 | Providence Physician Practices LLC | Family Medicine | 2435 Forest Dr, Columbia, SC 29204-2026 | 2016-02-05 |
| 1902264971 | Providence Physician Practices LLC | Physiological Laboratory | 2750 Laurel St, Ste 104, Columbia, SC 29204-2038 | 2016-02-05 |
| 1083072045 | Providence Physician Practices LLC | Nurse Anesthetist, Certified Registered | 2435 Forest Dr, Columbia, SC 29204-2026 | 2016-02-05 |
| 1689030595 | Providence Physician Practices LLC | Internal Medicine | 2001 Laurel St, Ste 300, Columbia, SC 29204-1018 | 2016-01-07 |
| Street Address |
1655 BERNARDIN AVE STE 350 |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29204-2039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235138819 | Stephen Harmes Humphrey | Internal Medicine | 1655 Bernardin Ave, Suite 220, Columbia, SC 29204-2039 | 2005-07-18 |
| 1194264465 | Anna M Evans | Nurse Practitioner | 1655 Bernardin Ave, Pmob 3 Suite 220, Columbia, SC 29204-2039 | 2017-02-19 |
| 1760934673 | Falguni Patel | Physician Assistant | 1655 Bernardin Ave, Ste 240, Columbia, SC 29204-2039 | 2016-10-26 |
| 1396192001 | Providence Group Practices II, LLC | Internal Medicine | 1655 Bernardin Ave, Ste 220, Columbia, SC 29204-2039 | 2016-05-23 |
| 1689034548 | Providence Physician Practices LLC | Plastic Surgery | 1655 Bernardin Ave, Ste 110, Columbia, SC 29204-2039 | 2016-03-04 |
| 1629457650 | Palmetto Pain Management, LLC | Non-Pharmacy Dispensing Site | 1655 Bernardin Ave, Suite 240, Columbia, SC 29204-2039 | 2015-05-22 |
| 1023410370 | Sabrina Marina Hilbert | Nurse Practitioner | 1655 Bernardin Ave, Suite 350, Columbia, SC 29204-2039 | 2014-09-18 |
| 1568899581 | Augustine Health Group | Surgery | 1655 Bernardin Ave, Suite 110, Columbia, SC 29204-2039 | 2013-10-04 |
| 1073833489 | Providence Pulmonary Specialists, LLC | Internal Medicine | 1655 Bernardin Ave, Suite 350, Columbia, SC 29204-2039 | 2010-06-08 |
| 1831414481 | Beau Taylor Bryan | Ophthalmology | 1655 Bernardin Ave, Suite 100, Columbia, SC 29204-2039 | 2010-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992215149 | Ricardo Colon II | Registered Nurse | 3000 Hampton Street, Columbia, SC 29204 | 2017-10-02 |
| 1780113522 | Carla Star Noe | Registered Nurse | Sc Department of Health and Environmental Control, 2100 Bull Street, Collumbia, SC 29204 | 2017-06-06 |
| 1124568514 | Kristy L Thompson | Nurse Practitioner | 1655 Bernardin Ave Ste 240, Columbia, SC 29204 | 2017-03-03 |
| 1982052031 | Harold Eugene Cook Iv | Podiatrist | 1730 St Julian Place, Columbia, SC 29204 | 2016-05-31 |
| 1851748974 | Shaquita Banks | Counselor | 1810 Allen Benedict Ct, A1, Columbia, SC 29204 | 2016-05-18 |
| 1265804835 | Premier Care, LLC | Case Management | 2712 Middleburg Drive, Suite 206, Columbia, SC 29204 | 2015-10-22 |
| 1023492287 | Shamiquia N. Mcpherson | Counselor | 1627 Auburn St., Columbia, SC 29204 | 2015-07-16 |
| 1285028449 | The Columbia Free Medical Clinic, Inc. | Clinic/Center | 1875 Harden Street, Columbia, SC 29204 | 2015-03-26 |
| 1629473459 | Leslie Wilson | Counselor | 2323 Lady Street, Columbia, SC 29204 | 2014-10-22 |
| 1053728683 | Candyce Sutton | Social Worker | 1135 Carter Street, Columbia, SC 29204 | 2014-07-15 |
| Find all providers in zip 29204 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1851671689 | Mid-mo Lung Associates, LLC | Internal Medicine | 1801 Brookfield Mnr, Columbia, MO 65203-6246 | 2011-08-24 |
| 1518259977 | Hina Chaudhry | Internal Medicine | 2750 Laurel St Ste 200a, Columbia, SC 29204-2038 | 2011-05-04 |
| 1295820934 | Jairaj Prashad | Internal Medicine | 1444 Barnwell St, Suite B, Columbia, SC 29201 | 2006-10-04 |
| 1740391259 | Lawrence M Lampton | Internal Medicine | 1504 E Broadway, Suite 218, Columbia, MO 65201-8077 | 2006-08-31 |
| 1417914474 | Tareq M. Abu Salah | Internal Medicine | 1705 East Broadway, Suite 280, Columbia, MO 65201-7185 | 2006-04-26 |
| 1467426650 | William Campbell Mclain IIi | Internal Medicine | 700 Gervais St, Suite 200, Columbia, SC 29201-3047 | 2006-02-14 |
| 1871571729 | Joseph D Love | Internal Medicine | 1333 Taylor St, Ste 6f, Columbia, SC 29201-2923 | 2006-01-02 |
| 1922587054 | Midlands Pulmonary and Critical Care Specialists, PC | Internal Medicine | 1655 Bernardin Ave Ste 350, Columbia, SC 29204-2039 | 2018-08-09 |
| 1710476882 | Palmetto Health - University of South Carolina Medical Group | Internal Medicine | 1 Richland Medical Park Dr Ste 300, Columbia, SC 29203-6831 | 2018-05-04 |
| 1629567771 | Palmetto Health - University of South Carolina Medical Group | Internal Medicine | 1333 Taylor St Ste 6f, Columbia, SC 29201-2953 | 2018-05-04 |
| 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.