NPIMap

Organization Active NPI

Colonial Family Practice, LLC

Doing business as Colonial Pain Management

  • Sports Medicine (Family Medicine) Physician
  • Sumter, SC
National Provider Identifier
1831435429
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
Legal business name
COLONIAL FAMILY PRACTICE, LLC
Doing business as
Colonial Pain Management
Colonial Sports Medicine, Joint, & Arthritis Clinic
Practice address
325 Broad St Ste 200
Sumter, SC 29150-4167
Phone
(803) 773-5227
Fax
(803) 418-0202
NPI assigned
Dec 31, 2012
Last updated
Oct 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Authorized official

Name
Joy Kimball
Title
Contract Manager
Phone
(803) 256-1511

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X
Pain Medicine (Anesthesiology) Physician 207LP2900X
Family Medicine Physician 207Q00000X
Sports Medicine (Family Medicine) Physician 207QS0010X Primary

Addresses

Primary practice location

325 Broad St Ste 200
Sumter, SC 29150-4167

Mailing address

674 W Liberty St
Sumter, SC 29150-4882
Phone (803) 773-5227

Other names 2

  • Colonial Pain Management Doing business as
  • Colonial Sports Medicine, Joint, & Arthritis Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040727000107 SC Part B Supplier - Clinic/Group Practice 9931017118 Receives reassigned benefits from 88 practitioners
23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sumter, SC; Camden, SC; Manning, SC; Columbia, SC

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory

Locations

1013 Professional Ct
Ste A
Manning, SC 29102
Phone (803) 433-7425

698 Bultman Dr
#A
Sumter, SC 29150
Phone (803) 774-2191

Practitioners & affiliated clinicians

Practitioners 83

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 83

NPI Registry JSON

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

{
    "created_epoch": "1356912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760054400000",
    "number": "1831435429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "674 W LIBERTY ST",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291504882",
            "telephone_number": "803-773-5227",
            "fax_number": "803-757-4010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 BROAD ST STE 200",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291504167",
            "telephone_number": "803-773-5227",
            "fax_number": "803-418-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONIAL FAMILY PRACTICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-31",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A",
        "authorized_official_last_name": "KIMBALL",
        "authorized_official_first_name": "JOY",
        "authorized_official_title_or_position": "CONTRACT MANAGER",
        "authorized_official_telephone_number": "803-256-1511"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colonial Pain Management",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Colonial Sports Medicine, Joint, & Arthritis Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sumter, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.