NPIMap

Organization Active NPI

Capitol ER Group LLC

  • Emergency Medicine Physician
  • Columbia, SC
National Provider Identifier
1366547101
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
CAPITOL ER GROUP LLC
Practice address
120 Gateway Corporate Blvd
Columbia, SC 29203-9802
Phone
(803) 865-4500
NPI assigned
Sep 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2008

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

Authorized official

Name
David C Winn, MDNPI 1730283029
Title
Finance Officer Member
Phone
(800) 657-7103

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

120 Gateway Corporate Blvd
Columbia, SC 29203-9802

Mailing address

PO Box 12350
Westminster, CA 92685-2350
Phone (800) 657-7104

Other identifiers 2

IdentifierTypeStateIssuer
GP4107MedicaidSC
GP4106MedicaidSC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1366547101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12350",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926852350",
            "telephone_number": "800-657-7104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 GATEWAY CORPORATE BLVD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292039802",
            "telephone_number": "803-865-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITOL ER GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "WINN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "FINANCE OFFICER MEMBER",
        "authorized_official_telephone_number": "800-657-7103",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4107",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4106",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 May 15, 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.