Columbia ASC Northwest LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

ASF-076 Issued in SC

Legal business name

COLUMBIA ASC NORTHWEST LLC

Doing business as

Lake Murray Endoscopy Center

Practice address

190 Parkridge Dr
Suite 100
Columbia, SC 29212-1747

Phone

(803) 407-6767

Fax

(803) 407-6757

NPI assigned

Feb 13, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Phillip Clendenin

Title

President

Phone

(615) 665-1283

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lake Murray Endoscopy Center Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Columbia Gastroenterology Associates PA

  • Gastroenterology Physician
  • Columbia, SC
  • NPI 1922080266

  Member Of

  NPD member

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1063486504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1A BURTON HILLS BLVD",
            "address_2": "ATTN: L&C",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156103",
            "telephone_number": "803-407-6767",
            "fax_number": "803-407-6757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 PARKRIDGE DR",
            "address_2": "SUITE 100",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292121747",
            "telephone_number": "803-407-6767",
            "fax_number": "803-407-6757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA ASC NORTHWEST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-13",
        "last_updated": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "CLENDENIN",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "SC",
            "license": "ASF-076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ASC048",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Murray Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Columbia Area Mental Health
• Columbia Area Mental Health
• Columbia Area Mental Health
• Columbia Arthritis Center, PA
• Columbia ASC LLC (Columbia Gastrointestinal Endoscopy Center)
• Columbia Audiology Group
• Columbia Cardiology
• Columbia Cardiology, LLC
• Columbia Cardiology, LLC
• Columbia Central (Central Columbia)

• Ambulatory Surgical Clinic/Center in Columbia, SC
• Providers in Columbia, SC by specialty
• Ambulatory Surgical Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.