| Providence Womens Health | |
|
114 Gateway Corp Blvd Suite 350 Augustine Health Group Llc Columbia SC 29203-9802 | |
| (803) 865-4780 | |
| (803) 865-4932 |
| Full Name | Providence Womens Health |
|---|---|
| Speciality | Obstetrics & Gynecology |
| Location | 114 Gateway Corp Blvd, Columbia, South Carolina |
| Authorized Official Name and Position | Lisa B Ham (MGR GENERAL ACCOUNTING) |
| Authorized Official Contact | 8038654583 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Womens Health 114 Gateway Corp Blvd Suite 425 Columbia SC 29203-9802 Ph: (803) 865-4780 | Providence Womens Health 114 Gateway Corp Blvd Suite 350 Augustine Health Group Llc Columbia SC 29203-9802 Ph: (803) 865-4780 |
| NPI Number | 1821051392 |
|---|---|
| Provider Enumeration Date | 04/07/2006 |
| Last Update Date | 04/20/2008 |
| Medicare PECOS PAC ID | 8628973443 |
|---|---|
| Medicare Enrollment ID | O20031204000917 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821051392 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 25087 (South Carolina) | Secondary |
| 207V00000X | Obstetrics & Gynecology | 21388 (South Carolina) | Primary |
| Provider Name | Gokul Gondi |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1831289123 PECOS PAC ID: 5698673804 Enrollment ID: I20031226000103 |
| Provider Name | Mulugeta Tarekegne |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336105535 PECOS PAC ID: 7618860768 Enrollment ID: I20040204000103 |
| Provider Name | Bradley A Clayton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659419869 PECOS PAC ID: 4082509294 Enrollment ID: I20040217000783 |
| Provider Name | Joel W Duncan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1871542779 PECOS PAC ID: 2961481775 Enrollment ID: I20040715000934 |
| Provider Name | Dana M Nairn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801843529 PECOS PAC ID: 1850362237 Enrollment ID: I20040802000610 |
| Provider Name | Gerald Conrad Bauknight |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1144279084 PECOS PAC ID: 8325089188 Enrollment ID: I20050523000111 |
| Provider Name | Gary B Bell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689640922 PECOS PAC ID: 8628003860 Enrollment ID: I20050927001012 |
| Provider Name | Leroy J Huffman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881689032 PECOS PAC ID: 0840283644 Enrollment ID: I20051005000912 |
| Provider Name | Thomas Cole Austin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1710958020 PECOS PAC ID: 4082621099 Enrollment ID: I20060316000288 |
| Provider Name | Donna S Cambron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093721136 PECOS PAC ID: 6002825106 Enrollment ID: I20060418000704 |
| Provider Name | Roland Ryhstmas Craft |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1427176544 PECOS PAC ID: 2264530021 Enrollment ID: I20070604000096 |
| Provider Name | Donald M Millus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811964612 PECOS PAC ID: 6507956547 Enrollment ID: I20071214000261 |
| Provider Name | Laura Elizabeth Hamilton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033390661 PECOS PAC ID: 6709962624 Enrollment ID: I20080318000503 |
| Provider Name | Daniel P Bouknight |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1427057009 PECOS PAC ID: 7113009259 Enrollment ID: I20080408000241 |
| Provider Name | Rodney Glenn Rhinehart |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1932108610 PECOS PAC ID: 4284716325 Enrollment ID: I20080408000256 |
| Provider Name | Allison K Hamada |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831304880 PECOS PAC ID: 3678652872 Enrollment ID: I20080429000704 |
| Provider Name | Jerome M Davis |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1053370361 PECOS PAC ID: 7618955576 Enrollment ID: I20080702000253 |
| Provider Name | Charlie W Devlin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1316987860 PECOS PAC ID: 7416021472 Enrollment ID: I20080808000549 |
| Provider Name | Leon J Khoury |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1467498014 PECOS PAC ID: 9436186954 Enrollment ID: I20080811000695 |
| Provider Name | Norma M Khoury |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1588606263 PECOS PAC ID: 1052486446 Enrollment ID: I20080820000060 |
| Provider Name | Michael C Foster |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1780625269 PECOS PAC ID: 9436224839 Enrollment ID: I20080820000137 |
| Provider Name | John T Beard |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1437149770 PECOS PAC ID: 3971678103 Enrollment ID: I20080821000555 |
| Provider Name | Nehal Desai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801855622 PECOS PAC ID: 0941377071 Enrollment ID: I20080916000182 |
| Provider Name | Jaiprakash N Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245290402 PECOS PAC ID: 2567539604 Enrollment ID: I20080916000200 |
| Provider Name | Robert M Malanuk |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1740242304 PECOS PAC ID: 3779643523 Enrollment ID: I20081124000384 |
| Provider Name | Benedict R Studnicka |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336198274 PECOS PAC ID: 1456416304 Enrollment ID: I20090210000518 |
| Provider Name | Audrey Stapleton Alleyne |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1164522694 PECOS PAC ID: 6901940386 Enrollment ID: I20100223000703 |
| Provider Name | Gandhi Gondi |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1487744777 PECOS PAC ID: 0143350884 Enrollment ID: I20100607000883 |
| Provider Name | Nicole Y Edwards |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639378987 PECOS PAC ID: 7113057068 Enrollment ID: I20100619000053 |
| Provider Name | Charis P Taylor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407036734 PECOS PAC ID: 8224182241 Enrollment ID: I20100803001041 |
| Provider Name | Kim B Edford-davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629269311 PECOS PAC ID: 7315131455 Enrollment ID: I20101102000944 |
| Provider Name | Maria M Modesto |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134235336 PECOS PAC ID: 0749380061 Enrollment ID: I20110113000841 |
| Provider Name | Nikki A Keisler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740441757 PECOS PAC ID: 0042480568 Enrollment ID: I20110818000904 |
| Provider Name | Beverly Huegel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578602546 PECOS PAC ID: 7911001052 Enrollment ID: I20111103000752 |
| Provider Name | Robert Y Beesburg |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1083673008 PECOS PAC ID: 0941474894 Enrollment ID: I20111110000910 |
| Provider Name | Nusrat Ul Shafi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083802490 PECOS PAC ID: 8022272962 Enrollment ID: I20120605000806 |
| Provider Name | James Michael Fields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871542571 PECOS PAC ID: 2769553718 Enrollment ID: I20120919000521 |
| Provider Name | Ian D Smith |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1306869060 PECOS PAC ID: 2668622911 Enrollment ID: I20121022000539 |
| Provider Name | Stephen Mullaney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841525227 PECOS PAC ID: 7315089588 Enrollment ID: I20130923000228 |
| Provider Name | Jessica D Peelle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295165207 PECOS PAC ID: 8628207446 Enrollment ID: I20140127000980 |
| Provider Name | Michelle T Tran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851608020 PECOS PAC ID: 0749431138 Enrollment ID: I20140321001160 |
| Provider Name | Benjamin Ellis Rawls |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003831710 PECOS PAC ID: 3173421492 Enrollment ID: I20140521001834 |
| Provider Name | Robert L Mcclain |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1952628752 PECOS PAC ID: 9032357413 Enrollment ID: I20150619001203 |
| Provider Name | William Mcilver Leppard |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1023218351 PECOS PAC ID: 1052532538 Enrollment ID: I20150811005751 |
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 | |
South Carolina Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1320 Main St Ste 300, Columbia, SC 29201 Phone: 657-400-5180 | |
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 |