Relymd Medical Group SC, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

RELYMD MEDICAL GROUP SC, LLC

Practice address

2 Office Park CT Ste 103
Columbia, SC 29223-5948

Phone

(919) 932-0928

NPI assigned

Sep 22, 2020

Organization subpart

Yes

Parent organization

RELYMD MEDICAL GROUP, LLCAs reported in NPPES

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

Authorized official

Name

Ronald Michael Creatore

Title

Cfo/General Counsel

Phone

(919) 932-0928

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• RelyMD Medical Group Doing business as

Part of

Relymd Medical Group LLC

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600732800000",
    "number": "1841806189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 MEADOWMONT VILLAGE CIR STE 323",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275177584",
            "telephone_number": "919-932-0928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 OFFICE PARK CT STE 103",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292235948",
            "telephone_number": "919-932-0928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RELYMD MEDICAL GROUP SC, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RELYMD MEDICAL GROUP, LLC",
        "enumeration_date": "2020-09-22",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A",
        "authorized_official_last_name": "CREATORE",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO/GENERAL COUNSEL",
        "authorized_official_telephone_number": "919-932-0928"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF SOUTH CAROLINA",
            "identifier": "200922-0911318",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RelyMD Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; 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.