Creek Way Psychiatry, LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

31795 Issued in SC

Legal business name

CREEK WAY PSYCHIATRY, LLC

Practice address

1415 Blanding St
Ste 4
Columbia, SC 29201-2922

Phone

(803) 779-7500

Fax

(803) 779-7522

NPI assigned

Oct 21, 2015

Organization subpart

No

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

Authorized official

Name

Kelly W Dion, M.D.

Title

Owner

Phone

(803) 779-7500

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1445385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445385600000",
    "number": "1518339282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 BLANDING ST",
            "address_2": "STE 4",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012922",
            "telephone_number": "803-779-7500",
            "fax_number": "803-779-7522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 BLANDING ST",
            "address_2": "STE 4",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012922",
            "telephone_number": "803-779-7500",
            "fax_number": "803-779-7522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEK WAY PSYCHIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-21",
        "last_updated": "2015-10-21",
        "status": "A",
        "authorized_official_last_name": "DION",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-779-7500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "31795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Psychiatry Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2015; 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.