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PROVIDENCE ORTHOPAEDIC GROUP LLC NPI 1255308342


NPI Information

NPI: 1255308342
Provider Name: PROVIDENCE ORTHOPAEDIC GROUP LLC

Doing Business As: MOORE ORTHOPAEDIC CLINIC

Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Organization
Address:
14 MEDICAL PARK RD
SUITE 200
COLUMBIA, SC
ZIP 29203
Phone: (803) 227-8152
Get Directions

PROVIDENCE ORTHOPAEDIC GROUP LLC is an orthopaedic surgery in Columbia, SC. The provider is an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. PROVIDENCE ORTHOPAEDIC GROUP LLC NPI is 1255308342. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Moore Orthopaedic Clinic.

The provider's business location address is:

14 MEDICAL PARK RD
SUITE 200
COLUMBIA, SC
ZIP 29203-877
Phone: (803) 227-8152
Fax: (803) 227-8011

The provider's authorized official is Sean P. Mcnally .
The authorized official title is Ceo and has the following contact phone number (803) 227-8152.

The enumeration date for this NPI number is 3/7/2006 and was last updated on 10/22/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207X00000XOrthopaedic Surgery570521956SOUTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1DM0194OTHERSOUTH CAROLINAMEDICAID DME#
2PA0686MEDICAIDSOUTH CAROLINA
30497990001MEDICARE NSCSOUTH CAROLINA
40497990001OTHERSOUTH CAROLINAMEDICARE DME#
59533MEDICARE UPINSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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