Providence Physician Practices LLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

PROVIDENCE PHYSICIAN PRACTICES LLC

Practice address

2435 Forest Dr
Columbia, SC 29204-2026

Phone

(803) 256-5300

NPI assigned

Feb 5, 2016

Organization subpart

No

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

Authorized official

Name

Jess Judy

Title

President

Phone

(615) 920-7000

Specialties & licenses 2

Addresses

Other names 1

• ANESTHESIA ASSOCIATES OF PROVIDENCE Doing business as

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

{
    "created_epoch": "1454630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487721600000",
    "number": "1083072045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 GATEWAY CORPORATE BLVD",
            "address_2": "STE 425",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292039740",
            "telephone_number": "803-865-4780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 FOREST DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042026",
            "telephone_number": "803-256-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE PHYSICIAN PRACTICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-05",
        "last_updated": "2017-02-22",
        "status": "A",
        "authorized_official_last_name": "JUDY",
        "authorized_official_first_name": "JESS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ANESTHESIA ASSOCIATES OF PROVIDENCE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Providence Orthopaedic Group, LLC
• Providence Orthopedic Group, LLC
• Providence Orthopedic Group, LLC
• Providence Pathology Associates PA
• Providence Physician Practices LLC
• Providence Physician Practices LLC
• Providence Physician Practices LLC
• Providence Physician Practices LLC
• Providence Physician Practices LLC
• Providence Physician Practices LLC

• Anesthesiology Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Anesthesiology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; 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.