Active NPI
Larry B. Mellick, MD
- Emergency Medicine Physician
- Columbia, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 22864
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G60514 | Medicaid | SC | |
| 000729319A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA, TX, SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22864 | SC | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sound Physicians Emergency Medicine of South Carolina LLC | Emergency Medicine | Current | Accepting new patients |
| Emergency Group of Columbus, LLC | Emergency Medicine | Current | Accepting new patients |
| Au Medical Associates Inc | Current | Accepting new patients | |
| Au Medical Associates Emergency Medicine Billing Services, LLC | Emergency Medicine | Current | Accepting new patients |
| Nueces Emergency Medicine Associates PA | Emergency Medicine | Current | Accepting new patients |
| Prisma Health Medical Group-Midlands | Current | Accepting new patients | |
| Hospitalist Medicine Physicians of Georgia-TCG, PC | Emergency Medicine | Current | Accepting new patients |
| Prisma Health Medical Group-Midlands | Emergency Medicine | Current | Accepting new patients |
| Au Medical Associates Inc | Current | 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
- 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.
-
- Multi-Specialty Clinic/Center
- Columbia, SC
- NPI 1275988321
Emergency Medicine
-
- Emergency Medicine Physician
- Aiken, SC
- NPI 1730636168
-
- Emergency Medicine Physician
- Augusta, GA
- NPI 1982089777
-
- Multi-Specialty Clinic/Center
- Augusta, GA
- NPI 1841230620
-
- Emergency Medicine Physician
- Columbus, GA
- NPI 1316458227
-
- Emergency Medicine Physician
- Savannah, GA
- NPI 1306325840
-
- Emergency Medicine Physician
- Corpus Christi, TX
- NPI 1215314364
-
- Durable Medical Equipment & Medical Supplies
- Columbia, SC
- NPI 1881469856
-
- Durable Medical Equipment & Medical Supplies
- Augusta, GA
- NPI 1114574126
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Aiken, SC
- NPI 1447437157
-
- General Acute Care Hospital
- Aiken, SC
- NPI 1467448498
-
- Neurological Surgery Physician
- Aiken, SC
- NPI 1942610928
Hospital
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.