NPIMap

Organization Active NPI

Melton R Stuckey

Doing business as Columbia Family Practice

  • Family Medicine Physician
  • Columbia, SC
National Provider Identifier
1336184837
Registry record updated Jan 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MELTON R STUCKEY
Doing business as
Columbia Family Practice
Practice address
1333 Taylor St
Suite 5-E
Columbia, SC 29201-2923
Phone
(803) 256-1518
Fax
(803) 256-9719
NPI assigned
Jun 18, 2006
Last updated
Jan 20, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2010

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

Authorized official

Name
Melton R Stuckey, MDNPI 1861463432
Title
Owner
Phone
(803) 254-2222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1333 Taylor St
Suite 5-E
Columbia, SC 29201-2923

Mailing address

PO Box 11098
Columbia, SC 29211-1098
Phone (803) 296-7305

Other identifiers 1

IdentifierTypeStateIssuer
GP0186MedicaidSC

Other names 1

  • Columbia Family Practice Doing business as

National Provider Directory

National Provider Directory

Locations

1333 Taylor St
Ste 5E
Columbia, SC 29201
Phone (803) 256-1518

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263945600000",
    "number": "1336184837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11098",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292111098",
            "telephone_number": "803-296-7305",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 TAYLOR ST",
            "address_2": "SUITE 5-E",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012923",
            "telephone_number": "803-256-1518",
            "fax_number": "803-256-9719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELTON R STUCKEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2010-01-20",
        "status": "A",
        "authorized_official_last_name": "STUCKEY",
        "authorized_official_first_name": "MELTON",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-254-2222",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0186",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Columbia Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; 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.