Colonial Family Practice NE

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25856 Issued in SC

Legal business name

COLONIAL FAMILY PRACTICE NE

Practice address

11 Gateway Corners Park
Columbia, SC 29203-8902

Phone

(803) 773-5227

Fax

(803) 462-0375

NPI assigned

Aug 1, 2013

Organization subpart

Yes

Parent organization

COLONIAL FAMILY PRACTICE, LLCAs reported in NPPES

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

Authorized official

Name

Ms. Leslie M. Alexander

Title

Credentialing

Phone

(803) 773-5227

Specialties & licenses 2

Addresses

Part of

Colonial Family Practice NE

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

{
    "created_epoch": "1375315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380672000000",
    "number": "1285066233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 BROAD ST",
            "address_2": "SUITE 100",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291504167",
            "telephone_number": "803-773-5227",
            "fax_number": "803-753-9121"
        },
        {
            "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": "803-773-5227",
            "fax_number": "803-462-0375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONIAL FAMILY PRACTICE NE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLONIAL FAMILY PRACTICE, LLC",
        "enumeration_date": "2013-08-01",
        "last_updated": "2013-10-02",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "803-773-5227",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "25856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Toya Renee Collins, LPC-A
• Tracey Moats Collins, RPH
• Michelle Carolyn Collymore
• Ricardo Colon II, RN
• Colonial Family Practice & Ambulatory Care Center
• Colonial Family Practice, LLC
• Bailey Colquitt, LPC
• Shenita Renea Colson, APRN
• Charlotte Colt
• Debra Colter, RT

• Family Medicine Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; 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.