| South Carolina | |
|
1320 Main St Ste 300 Columbia SC 29201-3266 | |
| (657) 400-5180 | |
| Not Available |
| Full Name | South Carolina |
|---|---|
| Speciality | General Practice |
| Location | 1320 Main St Ste 300, Columbia, South Carolina |
| Authorized Official Name and Position | Christopher Dennis (CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 6572372450 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Carolina 7755 Center Ave Ste 630 Huntington Beach CA 92647-9152 Ph: () - | South Carolina 1320 Main St Ste 300 Columbia SC 29201-3266 Ph: (657) 400-5180 |
| NPI Number | 1003531567 |
|---|---|
| Provider Enumeration Date | 10/07/2022 |
| Last Update Date | 01/30/2024 |
| Medicare PECOS PAC ID | 8527453851 |
|---|---|
| Medicare Enrollment ID | O20230206000153 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003531567 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Dwight Inghram Blair |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881618825 PECOS PAC ID: 2365494549 Enrollment ID: I20050216000167 |
| Provider Name | Stacy L Bizzell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427008432 PECOS PAC ID: 0547315244 Enrollment ID: I20090902000047 |
| Provider Name | Shereef Yehia El-ibiary |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265637425 PECOS PAC ID: 8426182593 Enrollment ID: I20100812000091 |
| Provider Name | Lucinda Demarco |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1184606428 PECOS PAC ID: 1850562281 Enrollment ID: I20131206000976 |
| Provider Name | Lorraine Archer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437455334 PECOS PAC ID: 2264663814 Enrollment ID: I20140324001054 |
| Provider Name | Adrienne L Hinton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780241182 PECOS PAC ID: 7012342199 Enrollment ID: I20200117001445 |
| Provider Name | Shernika Sheffield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447848544 PECOS PAC ID: 4981018041 Enrollment ID: I20210201001251 |
| Provider Name | Cheri Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255794855 PECOS PAC ID: 0840578068 Enrollment ID: I20210217000246 |
| Provider Name | Patricia Ann Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477144111 PECOS PAC ID: 1850709890 Enrollment ID: I20210413000186 |
| Provider Name | Sean Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255349064 PECOS PAC ID: 7012919301 Enrollment ID: I20230524000529 |
| Provider Name | Heather Danyel Fults |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659014751 PECOS PAC ID: 7214394667 Enrollment ID: I20230531001072 |
| Provider Name | Megan Goldsberry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275252017 PECOS PAC ID: 7113384116 Enrollment ID: I20230607000479 |
| Provider Name | Kasey Cushman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659818474 PECOS PAC ID: 1254615222 Enrollment ID: I20230621002236 |
| Provider Name | Andrea Dick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740927557 PECOS PAC ID: 8820456908 Enrollment ID: I20230621003583 |
| Provider Name | Lindsay Herron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164956884 PECOS PAC ID: 5890033328 Enrollment ID: I20230711000911 |
Palmetto Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 109 Barton Creek Ct, Columbia, SC 29229 Phone: 803-256-2286 Fax: 803-419-8430 | |
Northlake Family Medical Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3000 Ne Medical Park, Ste 101, Columbia, SC 29223 Phone: 803-419-5131 Fax: 803-419-5130 | |
Carolina Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3010 Farrow Rd, Suite 230, Columbia, SC 29203 Phone: 803-799-1284 Fax: 803-799-8148 | |
Lagniappe Medical Clinics, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 74 Polo Rd, Columbia, SC 29223 Phone: 803-419-7780 Fax: 803-419-7781 | |
Five Points Pediatrics Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1228 Harden St Ste B, Columbia, SC 29204 Phone: 803-748-7002 Fax: 803-252-5259 | |
Diabetes Educations Richland Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9 Medical Park Suite 205, Palmetto Health Richland Diabetes Education, Columbia, SC 29203 Phone: 803-296-2548 Fax: 803-296-3040 |