Active NPI
Larry Johnson
- Customized Equipment (DME)
- Columbia, SC
National Provider Identifier
1104618008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Customized Equipment (DME)
- Practice address
- 320 Pinnacle Ridge Dr
Columbia, SC 29229-7076 - Phone
- (803) 479-8185
- NPI assigned
- May 19, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Customized Equipment (DME) | 332BC3200X | SC | Primary |
Addresses
Primary practice location
320 Pinnacle Ridge Dr
Columbia, SC 29229-7076
Mailing address
320 Pinnacle Ridge Dr
Columbia, SC 29229-7076
Phone (803) 479-8185
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747612800000",
"number": "1104618008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 PINNACLE RIDGE DR",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292297076",
"telephone_number": "803-479-8185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 PINNACLE RIDGE DR",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292297076",
"telephone_number": "803-479-8185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "LARRY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-05-19",
"last_updated": "2025-05-19",
"certification_date": "2025-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "332BC3200X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
"state": "SC",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.