Providence Professional Services LLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

PROVIDENCE PROFESSIONAL SERVICES LLC

Practice address

2435 Forest Dr
Columbia, SC 29204-2026

Phone

(615) 920-7514

NPI assigned

Jan 30, 2017

Last updated

Jan 30, 2017By 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

Sara Miller

Title

Director

Phone

(615) 920-7514

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1485734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485734400000",
    "number": "1659818599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275098",
            "telephone_number": "615-920-7514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 FOREST DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042026",
            "telephone_number": "615-920-7514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE PROFESSIONAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-30",
        "last_updated": "2017-01-30",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "615-920-7514"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Providence Physician Practices LLC (Carolina Cardiovascular Associates)
• Providence Physician Practices LLC (Midlands Pulmonary, Critical Care & Sleep Medicine)
• Providence Physician Practices LLC (Laurel Imaging Center)
• Providence Physician Practices, LLC (Laurel Imaging Center)
• Providence Physician Practices, LLC (Providence Urology Specialists)
• Providence Pulmonary Specialists, LLC (Midlands Pulmonary, Critical Care & Sleep Medicine)
• Provident Place
• Providing Promises LLC
• Provision Healthcare, LLC
• Jessica Erin Hyatt Pruett, D.M.D

• Emergency Medicine Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Emergency Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; 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.