Augustine Health Group

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

AUGUSTINE HEALTH GROUP

Doing business as

Providence Surgical Associates

Practice address

1655 Bernardin Ave
Suite 110
Columbia, SC 29204-2039

Phone

(803) 409-7130

Fax

(803) 252-8280

NPI assigned

Oct 4, 2013

Last updated

Oct 7, 2013By 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

Kelly Mowrer

Title

Credentialing Specialist

Phone

(216) 472-2741

Specialties & licenses 1

Addresses

Other names 1

• Providence Surgical Associates Doing business as

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

{
    "created_epoch": "1380844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381104000000",
    "number": "1568899581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601964",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601964",
            "telephone_number": "855-477-2477",
            "fax_number": "216-472-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 BERNARDIN AVE",
            "address_2": "SUITE 110",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042039",
            "telephone_number": "803-409-7130",
            "fax_number": "803-252-8280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUGUSTINE HEALTH GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-04",
        "last_updated": "2013-10-07",
        "status": "A",
        "authorized_official_last_name": "MOWRER",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "216-472-2741"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Justin Henry Atwood, M.D.
• Jason Matthew Auch-Iler, APRN
• Audiology Services Company USA, LLC
• Alyssa Auer, RN
• Augustine Health Group (Providence Family Medicine Clemson Road)
• Augustine Health Group LLC (Providence Anesthesia Group)
• Augustine Health Group LLC (Providence Physical Medicine and Rehabilitation)
• Augustine Health Group LLC (Providence Womens Health)
• Augustine Health Group, LLC (Associates in Internal Medicine)
• Augustine Health Group, LLC (Providence Internal Medicine Northeast)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2013; 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.