Northlake Family Medical Practice

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

14862 Issued in SC

Legal business name

NORTHLAKE FAMILY MEDICAL PRACTICE

Practice address

3000 NE Medical Park
Ste 101
Columbia, SC 29223-6251

Phone

(803) 419-5131

Fax

(803) 419-5130

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Reginald L Parker, MDNPI 1790746709

Title

Owner

Phone

(803) 419-5131

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Reginald L Parker, MD

  • Family Medicine Physician
  • Columbia, SC
  • NPI 1790746709
  NPD Authorized official

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1003928680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 NE MEDICAL PARK",
            "address_2": "STE 101",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236251",
            "telephone_number": "803-419-5131",
            "fax_number": "803-419-5130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 NE MEDICAL PARK",
            "address_2": "STE 101",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236251",
            "telephone_number": "803-419-5131",
            "fax_number": "803-419-5130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAKE FAMILY MEDICAL PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "REGINALD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-419-5131",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "14862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4438",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northeast Medical Specialists
• Northeast Oral & Maxillofacial
• Northeast Oral & Maxillofacial Surgery Center
• Northeast Smile Center
• Northeast Speech-Language Pathology, LLC (Neslp)
• Northlake Family Practice
• Duncan Lee Norton, M.D.
• Jamie Maranda Norton, RN
• Michael Norton, D.C.
• Alison Kendra Norville, M.A.

• Family Medicine Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.