Augustine Health Group, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

AUGUSTINE HEALTH GROUP, LLC

Doing business as

Providence Family Medicine Cayce

Practice address

190 Knox Abbott Dr
Suite 3-C
Cayce, SC 29033-4348

Phone

(803) 865-4780

Fax

(803) 865-4932

NPI assigned

Jun 7, 2011

Last updated

Jun 7, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

SISTERS OF CHARITY PROVIDENCE HOSPITALAs reported in NPPES

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

Authorized official

Name

Angela Haithcock

Title

Credentialing Coordinator

Phone

(803) 865-4780

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Providence Family Medicine Cayce Doing business as

Part of

Providence Hospital

Locations

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307404800000",
    "number": "1639463771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 GATEWAY CORPORATE BLVD",
            "address_2": "SUITE 425",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292039740",
            "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": "190 KNOX ABBOTT DR",
            "address_2": "SUITE 3-C",
            "city": "CAYCE",
            "state": "SC",
            "postal_code": "290334348",
            "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": "SISTERS OF CHARITY PROVIDENCE HOSPITAL",
        "enumeration_date": "2011-06-07",
        "last_updated": "2011-06-07",
        "status": "A",
        "authorized_official_last_name": "HAITHCOCK",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "803-865-4780"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP #",
            "identifier": "DA2264",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Family Medicine Cayce",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Danielle Ardoin
• Mara Argyriou, PT
• Meredith Thomason Arnau, PT, MS, PCS
• Cathy Frola Arnot, PT, DPT, OCS
• Ezra Mozelle Ash-Malachi, MD
• Muma John Azeh, NCC, CCMHC, AND LPC
• Katherine Elizabeth Bailey, PT, DPT
• Peter A Bailey, M.D.
• Taylor Michelle Bankhead
• Valentine Baptiste- Thomas, LCSW

• Family Medicine Physician in Cayce, SC
• Providers in Cayce, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2011; 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.