Active NPI
Augustine Health Group LLC
- Physical Medicine & Rehabilitation Physician
- Columbia, SC
National Provider Identifier
1508036203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- Legal business name
- AUGUSTINE HEALTH GROUP LLC
- Practice address
- 114 Gateway Corporate Blvd
Suite 440
Columbia, SC 29203 - Phone
- (803) 865-4780
- Fax
- (803) 865-4932
- NPI assigned
- Mar 10, 2008
- Organization subpart
- Yes
- Parent organization
- AUGUSTINE HEALTH GROUP LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Regina Joy Frame
- Title
- Credentialing Coordinator
- Phone
- (803) 865-4780
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | Primary |
Addresses
Primary practice location
114 Gateway Corporate Blvd
Suite 440
Columbia, SC 29203
Mailing address
114 Gateway Corporate Blvd
Suite 440
Columbia, SC 29203
Phone (803) 865-4780
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP4785 | Medicaid | SC |
Other names 1
- Providence Physical Medicine and Rehabilitation
National Provider Directory
National Provider Directory- Part of
- Bradley a Clayton MD
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205107200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1205107200000",
"number": "1508036203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "114 GATEWAY CORPORATE BLVD",
"address_2": "SUITE 440",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "29203",
"telephone_number": "803-865-4780",
"fax_number": "803-865-4932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 GATEWAY CORPORATE BLVD",
"address_2": "SUITE 440",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "29203",
"telephone_number": "803-865-4780",
"fax_number": "803-865-4932"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AUGUSTINE HEALTH GROUP LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "AUGUSTINE HEALTH GROUP LLC",
"enumeration_date": "2008-03-10",
"last_updated": "2008-03-10",
"status": "A",
"authorized_official_last_name": "FRAME",
"authorized_official_first_name": "REGINA",
"authorized_official_middle_name": "JOY",
"authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
"authorized_official_telephone_number": "803-865-4780",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Medicine & Rehabilitation",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GP4785",
"state": "SC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Providence Physical Medicine and Rehabilitation",
"code": "3",
"type": "Doing Business As"
}
]
}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 10, 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.