Colonial Family Practice & Ambulatory Care Center
NPI 1902229214ActiveOrganization· Family Medicine· Columbia, SC
Family Medicine in Columbia, South Carolina, registered in NPPES in January 2014, part of Colonial Family Practice, LLC. The authorized official on file is Stephanie Knight Disher, Credentialing Manager.
Overview
| NPI | 1902229214 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Colonial Family Practice, LLC |
| NPI issued | Jan 23, 2014 |
| Last updated in NPPES | Mar 22, 2021 |
| Certified by provider | Mar 22, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | 25518 | SC |
| Emergency Medicine | 207P00000X | 28747 | SC |
| Clinic/Center, Endoscopy | 261QE0800X | 17676 | SC |
| Clinic/Center, Health Services | 261QH0100X | — | — |
| Clinic/Center, Magnetic Resonance Imaging (MRI) | 261QM1200X | 07-6916 GLENN GOUDY | SC |
| Physician Assistant | 363A00000X | — | — |
| Nurse Practitioner | 363L00000X | — | — |
| Nurse Practitioner, Family | 363LF0000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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