Dr Kelly Cho Harris, MD | |
114 Gateway Corporate Blvd Ste 420, Columbia, SC 29203-9785 | |
(803) 365-8650 | |
(803) 365-8659 |
Full Name | Dr Kelly Cho Harris |
---|---|
Gender | Male |
Speciality | General Surgery |
Experience | 14 Years |
Location | 114 Gateway Corporate Blvd Ste 420, Columbia, South Carolina |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1487974283 | NPI | - | NPPES |
612545 | Medicaid | SC | |
Q013673 | Medicaid | TN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 52928 (Tennessee) | Secondary |
208600000X | Surgery | 61254 (South Carolina) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Providence Health | Columbia, SC | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Musc Community Physicians | 6507260668 | 793 |
Columbia Nephrology Associates Pa | 9537128533 | 33 |
Entity Name | Columbia Nephrology Associates Pa |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1407821721 PECOS PAC ID: 9537128533 Enrollment ID: O20041006000242 |
Entity Name | Providence Physician Practices Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1285253336 PECOS PAC ID: 9638475627 Enrollment ID: O20160328001916 |
Entity Name | Musc Community Physicians |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1841878006 PECOS PAC ID: 6507260668 Enrollment ID: O20210811002388 |
Mailing Address | Practice Location Address |
---|---|
Dr Kelly Cho Harris, MD 330 Seven Springs Way, Brentwood, TN 37027-5098 Ph: (615) 920-7878 | Dr Kelly Cho Harris, MD 114 Gateway Corporate Blvd Ste 420, Columbia, SC 29203-9785 Ph: (803) 365-8650 |
Michael David Tichenor, MD Surgery Medicare: Medicare Enrolled Practice Location: Surgery Clinic, 1801 Sunset Drive, Columbia, SC 29203 Phone: 803-434-4166 Fax: 803-434-4183 | |
Ms. Taylor C Dieter, DNP, NP-C Surgery Medicare: Accepting Medicare Assignments Practice Location: 220 Graces Way, Columbia, SC 29229 Phone: 180-373-64560 | |
David Deaton, Surgery Medicare: Medicare Enrolled Practice Location: 2 Medical Park Rd Ste 300, Columbia, SC 29203 Phone: 803-545-5800 Fax: 803-254-0821 | |
Dr. Ginger Lynne Manos, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 3 Richland Medical Park Dr Ste 330, Columbia, SC 29203 Phone: 803-434-7100 Fax: 803-434-6889 | |
Dr. William Mciver Leppard, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 2750 Laurel St Ste 200, Columbia, SC 29204 Phone: 803-409-7130 Fax: 803-252-8280 | |
Dalton Shuler Prickett, M.D. F.A.C.S. Surgery Medicare: Not Enrolled in Medicare Practice Location: 1850 Laurel St, Columbia, SC 29201 Phone: 803-256-3400 Fax: 803-256-2039 | |
Dr. David Douglas Moffat Ii, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1850 Laurel St Ste 1a, Columbia, SC 29201 Phone: 803-376-5982 Fax: 803-376-5987 |