| Colonial Family Practice | |
|
325 Broad St. Ste 100 Sumter SC 29150-4167 | |
| (803) 773-5227 | |
| (803) 746-7445 |
| Full Name | Colonial Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 325 Broad St. Ste 100, Sumter, South Carolina |
| Authorized Official Name and Position | Clayton R Lowder (MD/CEO) |
| Authorized Official Contact | 8037735227 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Colonial Family Practice 325 Broad St. Ste 100 Sumter SC 29150-4167 Ph: (803) 773-5227 | Colonial Family Practice 325 Broad St. Ste 100 Sumter SC 29150-4167 Ph: (803) 773-5227 |
| NPI Number | 1518074640 |
|---|---|
| Provider Enumeration Date | 08/24/2006 |
| Last Update Date | 10/15/2019 |
| Medicare PECOS PAC ID | 9931017118 |
|---|---|
| Medicare Enrollment ID | O20040727000107 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518074640 | NPI | - | NPPES |
| GP3564 | Medicaid | SC | |
| GP6122 | Medicaid | SC | |
| GP6388 | Medicaid | SC | |
| GP6363 | Medicaid | SC | |
| GP6464 | Medicaid | SC | |
| GP6276 | Medicaid | SC | |
| GP6186 | Medicaid | SC | |
| GP6457 | Medicaid | SC |
| Provider Name | Carlos Andres Soto |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699787689 PECOS PAC ID: 9133105612 Enrollment ID: I20040625000452 |
| Provider Name | Mitchell R Grunsky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124105010 PECOS PAC ID: 5092785360 Enrollment ID: I20040727000130 |
| Provider Name | Winston B Morris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295791184 PECOS PAC ID: 9133179104 Enrollment ID: I20050127000295 |
| Provider Name | Robert Lee Ridgeway |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881689305 PECOS PAC ID: 0244292480 Enrollment ID: I20050510000050 |
| Provider Name | Ike Stewart |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255340329 PECOS PAC ID: 4082641931 Enrollment ID: I20050721000716 |
| Provider Name | Christopher M Mahr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801880190 PECOS PAC ID: 6709815970 Enrollment ID: I20050808000866 |
| Provider Name | William C Aldrich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356458061 PECOS PAC ID: 6800864695 Enrollment ID: I20060111000013 |
| Provider Name | Jason M Leonard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033290093 PECOS PAC ID: 0042219735 Enrollment ID: I20061206000404 |
| Provider Name | Jill C Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750482824 PECOS PAC ID: 2567565161 Enrollment ID: I20070417000002 |
| Provider Name | Dale S Barwick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114052255 PECOS PAC ID: 1951408228 Enrollment ID: I20070521000614 |
| Provider Name | Edward J Meyers |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1083631618 PECOS PAC ID: 8224083548 Enrollment ID: I20070605000230 |
| Provider Name | Gina G Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073581047 PECOS PAC ID: 0345334934 Enrollment ID: I20070913000021 |
| Provider Name | Pressley W Warrick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225238918 PECOS PAC ID: 1052480837 Enrollment ID: I20080520000346 |
| Provider Name | Paula A Anderson |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1568431674 PECOS PAC ID: 0446344915 Enrollment ID: I20080721000086 |
| Provider Name | Thomas L Lucas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477746998 PECOS PAC ID: 3274679790 Enrollment ID: I20091013000707 |
| Provider Name | Clayton Ralph Lowder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184671075 PECOS PAC ID: 0840108023 Enrollment ID: I20100924000966 |
| Provider Name | David Glenn Whaley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174630297 PECOS PAC ID: 1759299936 Enrollment ID: I20100929001069 |
| Provider Name | Carrie Judy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932195559 PECOS PAC ID: 9335338680 Enrollment ID: I20110118000980 |
| Provider Name | David R Trigg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134138167 PECOS PAC ID: 3779765367 Enrollment ID: I20110302000852 |
| Provider Name | Rebecca R Haskill Strowd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619995065 PECOS PAC ID: 5890979041 Enrollment ID: I20110412000820 |
| Provider Name | John Baker |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1598922130 PECOS PAC ID: 3870778939 Enrollment ID: I20110505000163 |
| Provider Name | Andrew J Mcmarlin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497719355 PECOS PAC ID: 1951307636 Enrollment ID: I20111227000195 |
| Provider Name | Lillian G Stukes Douglas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952643124 PECOS PAC ID: 2769625912 Enrollment ID: I20130906000876 |
| Provider Name | Tracie B Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760815088 PECOS PAC ID: 9335375054 Enrollment ID: I20131202000107 |
| Provider Name | Julie Miles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306238043 PECOS PAC ID: 5991025363 Enrollment ID: I20150527000076 |
| Provider Name | William G Byrd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801271465 PECOS PAC ID: 2860701265 Enrollment ID: I20151027000051 |
| Provider Name | Amber Ballentine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104243518 PECOS PAC ID: 4789984501 Enrollment ID: I20151201001517 |
| Provider Name | Carrie Hoshour |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467856930 PECOS PAC ID: 5991094849 Enrollment ID: I20160516001301 |
| Provider Name | Matthew Furman |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1013913813 PECOS PAC ID: 5597881813 Enrollment ID: I20160819001190 |
| Provider Name | Mary Kathleen Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871973339 PECOS PAC ID: 0446528962 Enrollment ID: I20170623001935 |
| Provider Name | Elizabeth B Brockinton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417328667 PECOS PAC ID: 7719250281 Enrollment ID: I20170905001486 |
| Provider Name | Barbara Jean Epps |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700391430 PECOS PAC ID: 4284994930 Enrollment ID: I20180129001370 |
| Provider Name | Grace Wielicki Couch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821565334 PECOS PAC ID: 2062756984 Enrollment ID: I20181204002623 |
| Provider Name | Samica Snipes-smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023576139 PECOS PAC ID: 8022351295 Enrollment ID: I20190510001674 |
| Provider Name | Joseph Walter Adams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841685112 PECOS PAC ID: 0648589770 Enrollment ID: I20190702001066 |
| Provider Name | Taylor Buck Owens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134774607 PECOS PAC ID: 5193054120 Enrollment ID: I20190917000349 |
| Provider Name | Kirsten April Becksvoort |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972964302 PECOS PAC ID: 5496049405 Enrollment ID: I20190919001807 |
| Provider Name | Krystal Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851718753 PECOS PAC ID: 2062848310 Enrollment ID: I20200204001712 |
| Provider Name | Michael Owen Ouzts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326576935 PECOS PAC ID: 5496029688 Enrollment ID: I20200710003079 |
| Provider Name | Yolanda Bryant |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023233129 PECOS PAC ID: 6305070517 Enrollment ID: I20210112000440 |
| Provider Name | Bridget Peters |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689231458 PECOS PAC ID: 5193057164 Enrollment ID: I20210611001726 |
| Provider Name | Stephanie Ann Stalker |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861985962 PECOS PAC ID: 8426394719 Enrollment ID: I20210728000065 |
| Provider Name | Angel Jeanine Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538739636 PECOS PAC ID: 2163827825 Enrollment ID: I20210819000391 |
| Provider Name | Tracy Barwick Mcintosh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700456837 PECOS PAC ID: 6901201078 Enrollment ID: I20210827001124 |
| Provider Name | Jill Smith Love |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558025015 PECOS PAC ID: 4880083732 Enrollment ID: I20211115000947 |
| Provider Name | Cody William Becksvoort |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831572619 PECOS PAC ID: 1658685342 Enrollment ID: I20211119001599 |
| Provider Name | Joselyn E Fair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851800148 PECOS PAC ID: 9739447244 Enrollment ID: I20220119001449 |
| Provider Name | Emily Defelice Weaver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417696188 PECOS PAC ID: 5799167474 Enrollment ID: I20220727001939 |
| Provider Name | Meghan Wachter Pmhnp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063173383 PECOS PAC ID: 6103200530 Enrollment ID: I20220901003209 |
| Provider Name | Honey Dawn Chapman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114653185 PECOS PAC ID: 4183091952 Enrollment ID: I20221108000870 |
| Provider Name | Joy Denise Mcdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376202838 PECOS PAC ID: 8820460066 Enrollment ID: I20230215002823 |
| Provider Name | Margaret Anne Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932868601 PECOS PAC ID: 9133589278 Enrollment ID: I20230720001759 |
| Provider Name | Riley Daniel Little |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588292569 PECOS PAC ID: 1951725753 Enrollment ID: I20230928002468 |
| Provider Name | Whitney Denise Thornton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932987278 PECOS PAC ID: 3678921244 Enrollment ID: I20231121002391 |
| Provider Name | Jordan Turner Atkinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346010881 PECOS PAC ID: 9436594645 Enrollment ID: I20240228000060 |
Genpsych Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2 Medical Ct, Sumter, SC 29150 Phone: 803-774-4020 Fax: 803-774-4025 | |
Counseling Sumter Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2645a Hardee Cv, Sumter, SC 29150 Phone: 803-720-9465 Fax: 803-526-7067 | |
Serenity Counseling Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 529 Oxford St Ste B, Sumter, SC 29150 Phone: 803-774-0147 Fax: 803-774-0149 | |
Carolina Behavioral Health Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 130 Broad St, Sumter, SC 29150 Phone: 803-774-4377 Fax: 803-774-4378 | |
Genpsych Of South Carolina, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2 Medical Ct, Sumter, SC 29150 Phone: 803-774-4020 Fax: 803-774-4025 | |
Acorns N Bones Omc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 710 Bultman Dr, Sumter, SC 29150 Phone: 803-883-4237 Fax: 803-883-4004 | |
Pathways To Life, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1155 N Guignard Dr, Suite 5, Sumter, SC 29150 Phone: 252-695-0269 Fax: 252-413-0526 |