Organization Active NPI

Thomas J Carzoli MD PA

  • Medical Specialty Clinic/Center
  • Columbia, SC
National Provider Identifier
1417317264
Registry record updated Mar 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
2580 Issued in SC
Legal business name
THOMAS J CARZOLI MD PA
Practice address
1301 Taylor St
Suite 5K
Columbia, SC 29201-2942
Phone
(803) 765-2090
NPI assigned
Mar 7, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2016

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

Authorized official

Name
Tammy B Willard
Title
Practice Manager
Phone
(803) 765-2090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 2580 SC Primary

Addresses

Primary practice location

1301 Taylor St
Suite 5K
Columbia, SC 29201-2942

Mailing address

1301 Taylor St
Suite 5K
Columbia, SC 29201-2942
Phone (803) 765-2090

Other identifiers 1

IdentifierTypeStateIssuer
LM0039MedicaidSC

National Provider Directory

National Provider Directory
Tax ID family
Thomas J Carzoli MD PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1301 Taylor St
Ste 5K
Columbia, SC 29201
Phone (803) 765-2090

NPI Registry JSON

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

{
    "created_epoch": "1457308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457308800000",
    "number": "1417317264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 TAYLOR ST",
            "address_2": "SUITE 5K",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012942",
            "telephone_number": "803-765-2090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 TAYLOR ST",
            "address_2": "SUITE 5K",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012942",
            "telephone_number": "803-765-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS J CARZOLI MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-07",
        "last_updated": "2016-03-07",
        "status": "A",
        "authorized_official_last_name": "WILLARD",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "803-765-2090"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "SC",
            "license": "2580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LM0039",
            "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 Mar 7, 2016; 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.