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COMMUNITY WELLNESS GROUP LLC NPI 1982144606


NPI Information

NPI: 1982144606
Provider Name: COMMUNITY WELLNESS GROUP LLC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
2430 ATLAS RD STE 1
COLUMBIA, SC
ZIP 29209
Phone: (803) 586-1752
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COMMUNITY WELLNESS GROUP LLC is an internal medicine in Columbia, SC. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. COMMUNITY WELLNESS GROUP LLC NPI is 1982144606. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2430 ATLAS RD STE 1
COLUMBIA, SC
ZIP 29209-625
Phone: (803) 586-1752
Fax: (877) 995-5934

The provider's authorized official is Kenneth Allan Simmons .
The authorized official title is Director/manager and has the following contact phone number (803) 586-1752.

The enumeration date for this NPI number is 2/28/2017 and was last updated on 12/7/2021.


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
1101YA0400XCounselorAddiction (Substance Use Disorder)No
2101YM0800XCounselorMental HealthNo
3101YP2500XCounselorProfessionalNo
4103T00000XPsychologistNo
5111N00000XChiropractorNo
6207R00000XInternal MedicineYes
7207RC0000XInternal MedicineCardiovascular DiseaseNo
82084P0800XPsychiatry & NeurologyPsychiatryNo
92083A0300XPreventive MedicineAddiction MedicineNo

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
1GP8968MEDICAIDSOUTH 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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