Kaoru Joan Pridgen, M.D., P.a.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

25856 Issued in SC

Legal business name

KAORU JOAN PRIDGEN, M.D., P.A.

Practice address

11 Gateway Corners Park
Columbia, SC 29203-8902

Phone

(803) 462-2335

Fax

(803) 462-0375

NPI assigned

Jun 27, 2007

Organization subpart

No

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

Authorized official

Name

Kaoru Joan Pridgen

Title

MD

Phone

(803) 462-2335

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219968000000",
    "number": "1235336082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 GATEWAY CORNERS PARK",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292038902",
            "telephone_number": "803-462-2335",
            "fax_number": "803-462-0375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 GATEWAY CORNERS PARK",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292038902",
            "telephone_number": "803-462-2335",
            "fax_number": "803-462-0375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAORU JOAN PRIDGEN, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2008-08-29",
        "status": "A",
        "authorized_official_last_name": "PRIDGEN",
        "authorized_official_first_name": "KAORU",
        "authorized_official_middle_name": "JOAN",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "803-462-2335"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "SC",
            "license": "25856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258562",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bobby Kannady Jr., PT
• Alan B Kantsiper, MD
• Michael Alan Kanwisher, MD
• Morgan Kanwisher, NP
• Alexandra Stromberg Kao, MS, CCC-SLP
• Lloyd McCrary Kapp Jr., M.D., F.A.A.P.
• Fred Guo Karaisz, MD
• Mutahammis Kareem, M.D.
• Marjan Karegar, M.D.
• Karing in Mind, LLC

• Primary Care Clinic/Center in Columbia, SC
• Providers in Columbia, SC by specialty
• Primary Care Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2008; 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.