Organization Active NPI

Columbia Cardiology, LLC

  • Specialist
  • West Columbia, SC
National Provider Identifier
1124222807
Registry record updated Nov 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
COLUMBIA CARDIOLOGY, LLC
Practice address
131 Sunset Court
West Columbia, SC 29169-3405
Phone
(803) 744-4900
Fax
(803) 499-2621
NPI assigned
Jun 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2011

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

Authorized official

Name
Tracy B Brown
Title
Bus. Office Supervisor
Phone
(803) 744-2612

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X

Addresses

Primary practice location

131 Sunset Court
West Columbia, SC 29169-3405

Mailing address

PO Box 4187
Columbia, SC 29240-4187
Phone (803) 744-4900

Other identifiers 1

IdentifierTypeStateIssuer
GP3493MedicaidSC

National Provider Directory

National Provider Directory
Tax ID family
Columbia Cardiology Con3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2601 Laurel St
Ste 260
Columbia, SC 29204
Phone (803) 744-7900

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320105600000",
    "number": "1124222807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4187",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292404187",
            "telephone_number": "803-744-4900",
            "fax_number": "803-744-2621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 SUNSET COURT",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693405",
            "telephone_number": "803-744-4900",
            "fax_number": "803-499-2621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA CARDIOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2011-11-01",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "BUS. OFFICE SUPERVISOR",
        "authorized_official_telephone_number": "803-744-2612"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3493",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.