NPIMap

Organization Active NPI

Augustine Health Group, LLC

  • Cardiovascular Disease Physician
  • Columbia, SC
National Provider Identifier
1740484658
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
AUGUSTINE HEALTH GROUP, LLC
Practice address
120 Gateway Corporate Blvd
Columbia, SC 29203-9611
Phone
(803) 256-5460
NPI assigned
Jun 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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

Authorized official

Name
Mr. Jeremy W Whitaker, CPC
Title
Manager
Phone
(803) 865-4798

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

120 Gateway Corporate Blvd
Columbia, SC 29203-9611

Mailing address

PO Box 60496
Charlotte, NC 28260-0496
Phone (803) 256-5460

Other identifiers 1

IdentifierTypeStateIssuer
GP4709MedicaidSC

Other names 1

  • Providence EKG Physicians Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1740484658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60496",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600496",
            "telephone_number": "803-256-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 GATEWAY CORPORATE BLVD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292039611",
            "telephone_number": "803-256-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUGUSTINE HEALTH GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "WHITAKER",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "803-865-4798",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4709",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence EKG Physicians",
            "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 Apr 29, 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.

Verify at the official NPI Registry.