NPIMap

Organization Active NPI

Providence Orthopaedic Group, LLC

  • Orthopaedic Surgery Physician
  • Columbia, SC
National Provider Identifier
1982913018
Registry record updated Jun 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
PROVIDENCE ORTHOPAEDIC GROUP, LLC
Practice address
114 Gateway Corporate Blvd
Suite 100
Columbia, SC 29203-9740
Phone
(803) 227-8000
NPI assigned
Oct 7, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2011

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

Authorized official

Name
Sean McNally
Title
Ceo
Phone
(803) 227-8152

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

114 Gateway Corporate Blvd
Suite 100
Columbia, SC 29203-9740

Mailing address

PO Box 9592
Belfast, ME 04915-9592
Phone (803) 227-8000

Other names 1

  • Moore Orthopaedic Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

114 Gateway Corporate Blvd
Ste 100
Columbia, SC 29203

NPI Registry JSON

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

{
    "created_epoch": "1286409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306972800000",
    "number": "1982913018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9592",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049159592",
            "telephone_number": "803-227-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 GATEWAY CORPORATE BLVD",
            "address_2": "SUITE 100",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292039740",
            "telephone_number": "803-227-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE ORTHOPAEDIC GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-07",
        "last_updated": "2011-06-02",
        "status": "A",
        "authorized_official_last_name": "MCNALLY",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "803-227-8152"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moore Orthopaedic Clinic",
            "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 Jun 2, 2011; 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.