NPIMap

Organization Active NPI

South Carolina Heart Center PA

  • Cardiovascular Disease Physician
  • West Columbia, SC
National Provider Identifier
1417119017
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
SOUTH CAROLINA HEART CENTER PA
Practice address
2728 Sunset Blvd
Ste 401
West Columbia, SC 29169-4840
Phone
(803) 794-3950
Fax
(803) 739-1485
NPI assigned
Jun 26, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2008

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

Authorized official

Name
Kathy Koenig
Title
Chief Financial Officer
Phone
(803) 254-3278

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X SC Primary

Addresses

Primary practice location

2728 Sunset Blvd
Ste 401
West Columbia, SC 29169-4840

Mailing address

PO Box 99
Columbia, SC 29202-0099
Phone (803) 254-3278

Other identifiers 1

IdentifierTypeStateIssuer
PC3787MedicaidSC

National Provider Directory

National Provider Directory
Tax ID family
South Carolina Heart Center PA9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

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": "1214438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1417119017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292020099",
            "telephone_number": "803-254-3278",
            "fax_number": "803-376-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2728 SUNSET BLVD",
            "address_2": "STE 401",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694840",
            "telephone_number": "803-794-3950",
            "fax_number": "803-739-1485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CAROLINA HEART CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-26",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "KOENIG",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "803-254-3278"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PC3787",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.