NPIMap

Organization Active NPI

Columbia Cardiology, LLC

  • Internal Medicine Physician
  • Lugoff, SC
National Provider Identifier
1184955684
Registry record updated Nov 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
COLUMBIA CARDIOLOGY, LLC
Practice address
1 The Common at Lugoff
Lugoff, SC 29078-8725
Phone
(803) 744-4900
Fax
(803) 744-2621
NPI assigned
Jan 22, 2010
Last updated
Nov 1, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
COLUMBIA CARDIOLOGY, LLCAs reported in NPPES

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
Business Office Supervisor
Phone
(803) 744-2612

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

1 The Common at Lugoff
Lugoff, SC 29078-8725

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
GP3493MedicaidSC
CJ9082OtherSCRR MEDICARE

National Provider Directory

National Provider Directory
Part of
Columbia Cardiology Con

Locations

2601 Laurel St
Ste 260
Columbia, SC 29204

1 The Common At Lugoff
Lugoff, SC 29078
Phone (803) 729-4610

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320105600000",
    "number": "1184955684",
    "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": "1 THE COMMON AT LUGOFF",
            "city": "LUGOFF",
            "state": "SC",
            "postal_code": "290788725",
            "telephone_number": "803-744-4900",
            "fax_number": "803-744-2621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA CARDIOLOGY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLUMBIA CARDIOLOGY, LLC",
        "enumeration_date": "2010-01-22",
        "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": "BUSINESS OFFICE SUPERVISOR",
        "authorized_official_telephone_number": "803-744-2612"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3493",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CJ9082",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lugoff, 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.