Individual provider Active NPI

Larry B. Mellick, MD

  • Emergency Medicine Physician
  • Columbia, SC
National Provider Identifier
1841309804
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
22864 Issued in SC
Practice address
14 Richland Medical Park Dr Ste 350
Columbia, SC 29203-6896
Phone
(803) 434-1663
Fax
(803) 434-1663
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 042892 GA
Emergency Medicine Physician 207P00000X 22864 SC Primary

Addresses

Primary practice location

14 Richland Medical Park Dr Ste 350
Columbia, SC 29203-6896

Mailing address

300 E McBee Ave Ste 300
Greenville, SC 29601-2899
Phone (864) 522-8603

Other practice location 1

1120 15th St
Augusta, GA 30912-0004
Phone (706) 721-4951

Other identifiers 2

IdentifierTypeStateIssuer
G60514MedicaidSC
000729319AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TX, SC3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20090603000383 GA Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 9133279615 Reassigns benefits to 4 organizations
I20250714003684 TX Practitioner - Emergency Medicine 9133279615 Reassigns benefits to 1 organization
I20260112000597 SC Practitioner - Emergency Medicine 9133279615 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Medical College of Ohio, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

120 Brentwood Commons Way
Suite 510
Brentwood, TN 37027-2028

1498 Pacific Ave
Suite 500
Tacoma, WA 98402-4208

300 E McBee Ave
FL 4
Greenville, SC 29601-2842

300 E McBee Ave
Suite 300
Greenville, SC 29601-2899

Hospital & facility affiliations

  • Aiken Regional Medical Center Hospital, Aiken, SC, CCN 420082

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22864SCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians Emergency Medicine of South Carolina LLC Emergency Medicine CurrentSince Aug 31, 2025 Accepting new patients
Emergency Group of Columbus, LLC Emergency Medicine CurrentSince Jun 25, 2025 Accepting new patients
Au Medical Associates Inc CurrentSince Oct 7, 1996 Accepting new patients
Au Medical Associates Emergency Medicine Billing Services, LLC Emergency Medicine CurrentSince Sep 1, 2015 Accepting new patients
Nueces Emergency Medicine Associates PA Emergency Medicine CurrentSince Jun 1, 2025 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Mar 30, 2026 Accepting new patients
Hospitalist Medicine Physicians of Georgia-TCG, PC Emergency Medicine CurrentSince Mar 1, 2025 Accepting new patients
Prisma Health Medical Group-Midlands Emergency Medicine CurrentSince Mar 30, 2026 Accepting new patients
Au Medical Associates Inc CurrentSince Oct 7, 1996 Accepting new patients

Locations

1499 Walton Way
Ste 1400
Augusta, GA 30901
Phone (706) 721-4951

1120 15th St
Bldg O107
Augusta, GA 30912

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

459 Highway 119 S
Springfield, GA 31329
Phone (912) 754-0200

200 Corporate Blvd
Lafayette, LA 70508

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

14 Richland Medical Park Dr
Ste 350
Columbia, SC 29203
Phone (803) 434-1663

3533 S Alameda St
Corpus Christi, TX 78411
Phone (361) 694-5445

2820 W Michaelangelo Dr
Edinburg, TX 78539
Phone (956) 342-0485

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1841309804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE STE 300",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012899",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 RICHLAND MEDICAL PARK DR STE 350",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036896",
            "telephone_number": "803-434-1663",
            "fax_number": "803-434-1663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1120 15th St",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309120004",
            "country_code": "US",
            "telephone_number": "706-721-4951",
            "fax_number": "706-721-7941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELLICK",
        "first_name": "LARRY",
        "middle_name": "B.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "GA",
            "license": "042892",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "22864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G60514",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000729319A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.