Providence Group Practices II, LLC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

PROVIDENCE GROUP PRACTICES II, LLC

Practice address

1330 Haile St
Camden, SC 29020-3002

Phone

(803) 434-6771

Fax

(803) 424-1900

NPI assigned

Sep 21, 2017

Organization subpart

No

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

Authorized official

Name

Sara Miller

Title

Director

Phone

(615) 920-7514

Specialties & licenses 5

Addresses

Other names 1

• Providence Cardiovascular Consultants Doing business as

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

{
    "created_epoch": "1505952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506297600000",
    "number": "1184133258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275098",
            "telephone_number": "16159207780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 HAILE ST",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290203002",
            "telephone_number": "803-434-6771",
            "fax_number": "803-424-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE GROUP PRACTICES II, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-21",
        "last_updated": "2017-09-25",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "615-920-7514"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Cardiovascular Consultants",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Providence Cardiovascular Consultants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jillian Marie Press, FNP
• Crystal Lynne Price, APRN, RN
• Pro-Motion Physical Therapy of Camden, SC, LLC
• Katherine Victoria Profit
• Providence Cardiology LLC
• Reahnita S Pulaski
• Quality Sleep Solutions Camden LLC
• Megan J Quigley, LMSW
• Xenia Ramos
• Celeste Hard Ranson, OTR/L

• Cardiovascular Disease Physician in Camden, SC
• Providers in Camden, SC by specialty
• Cardiovascular Disease Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.