Carolina Colon & Rectal

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

Legal business name

CAROLINA COLON & RECTAL

Practice address

1730 Saint Julian Place
Columbia, SC 29204-2410

Phone

(803) 779-2005

Fax

(803) 765-0007

NPI assigned

May 30, 2006

Last updated

Nov 29, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Ruth M Cornell

Title

Insurance Manager

Phone

(803) 779-2005

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CCRS Former legal business name

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196294400000",
    "number": "1437106788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 SAINT JULIAN PL",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042410",
            "telephone_number": "803-779-2005",
            "fax_number": "803-765-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 SAINT JULIAN PLACE",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042410",
            "telephone_number": "803-779-2005",
            "fax_number": "803-765-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA COLON & RECTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-30",
        "last_updated": "2007-11-29",
        "status": "A",
        "authorized_official_last_name": "CORNELL",
        "authorized_official_first_name": "RUTH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "INSURANCE MANAGER",
        "authorized_official_telephone_number": "803-779-2005",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PC0691",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCRS",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Colon & Rectal Surgery Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Colon & Rectal Surgery Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; 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.