Providence Cardiology LLC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

PROVIDENCE CARDIOLOGY LLC

Doing business as

Providence Cardiology

Practice address

124 Wren St
Barnwell, SC 29812-1527

Phone

(803) 254-3278

Fax

(803) 376-8010

NPI assigned

Sep 8, 2011

Last updated

Sep 8, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kathleen L Koenig

Title

Chief Financial Officer

Phone

(803) 254-3278

Specialties & licenses 1

Addresses

Other names 1

• Providence Cardiology Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1315440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315440000000",
    "number": "1003197666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 LAUREL ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292041018",
            "telephone_number": "803-254-3278",
            "fax_number": "803-376-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 WREN ST",
            "city": "BARNWELL",
            "state": "SC",
            "postal_code": "298121527",
            "telephone_number": "803-254-3278",
            "fax_number": "803-376-8010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE CARDIOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-08",
        "last_updated": "2011-09-08",
        "status": "A",
        "authorized_official_last_name": "KOENIG",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF  FINANCIAL OFFICER",
        "authorized_official_telephone_number": "803-254-3278"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Cardiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Palmetto Urology
• Mahima Kalpesh Patel
• Kiffany Perlote
• Kaylie Suzanne Pridgen
• Lindsey Priester
• Pruitthealth - Barnwell, LLC (PruittHealth - Barnwell)
• Susan Quach
• Jennifer Denise Rahn, M.D.
• Lauren Ashley Ray-Villalobos
• Alexis Victoria Ray

• Cardiovascular Disease Physician in Barnwell, SC
• Providers in Barnwell, SC by specialty
• Cardiovascular Disease Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.