Organization Active NPI

Core International LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1396417226
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
CORE INTERNATIONAL LLC
Practice address
1415 Blanding St Ste 4
Columbia, SC 29201-2922
Phone
(803) 779-7500
NPI assigned
Sep 29, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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

Authorized official

Name
Lisa Gardner
Title
Office Manager
Phone
(803) 779-7500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1415 Blanding St Ste 4
Columbia, SC 29201-2922

Mailing address

1415 Blanding St Ste 4
Columbia, SC 29201-2922
Phone (803) 779-7500

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address coreinternationalllc@ahutto.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240507002897 SC Part B Supplier - Clinic/Group Practice 6800237926 Receives reassigned benefits from 1 practitioner
Practice locations: Columbia, SC

National Provider Directory

National Provider Directory

Locations

1415 Blanding St
Ste 4
Columbia, SC 29201
Phone (803) 779-7500

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1632873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632873600000",
    "number": "1396417226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 BLANDING ST STE 4",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012922",
            "telephone_number": "803-779-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 BLANDING ST STE 4",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012922",
            "telephone_number": "803-779-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORE INTERNATIONAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-29",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "803-779-7500"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "coreinternationalllc@ahutto.com",
            "affiliation": "N",
            "address_1": "1415 Blanding St Ste 4",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292012922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Sep 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.