Colonial Family Practice Columbia

LBN: Colonial Family Practice & Ambulatory Care Center
Colonial Family Practice Columbia is an health care organization with primary practice located at 4700 Forest Dr , Columbia SC 29206. The organization recently has 8 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Endoscopy, Ambulatory Health Care Facilities / Health Service, Ambulatory Health Care Facilities / Magnetic Resonance Imaging (MRI), Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. Colonial Family Practice & Ambulatory Care Center can be contacted via phone (803) 773-5227, or through Disher, Stephanie Knight via phone (803) 773-5227.

Contact Information

Primary practice address
4700 Forest Dr Columbia SC 29206
Phone: (803) 773-5227
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Disher, Stephanie Knight
Phone: (803) 773-5227

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 28747 South Carolina
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 25518 South Carolina
Ambulatory Health Care Facilities / Endoscopy 261QE0800X 17676 South Carolina
Ambulatory Health Care Facilities / Health Service 261QH0100X
Ambulatory Health Care Facilities / Magnetic Resonance Imaging (MRI) 261QM1200X 07-6916 GLENN GOUDY South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X

Profile Details

NPI number 1902229214
LBN Legal business name Colonial Family Practice & Ambulatory Care Center
DBA Doing business as Colonial Family Practice Columbia
Authorized official Disher, Stephanie Knight
Entity Organization
Organization subpart 1 Yes
Enumeration date Jan 23rd, 2014
Last updated Mar 22nd, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902229214 NPPES
South Carolina MEDICAID GP3564

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