CONCIERGE MEDICAL GROUP LLC NPI 1811407521

NPI Information

  • NPI: 1811407521
  • Provider Name: CONCIERGE MEDICAL GROUP LLC
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • CLIA Number: 42D2154656
  • Address: 110 WILDEWOOD PARK DR STE A
    COLUMBIA, SC
    ZIP 29223
  • Phone: (803) 722-4988

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NPI Details

CONCIERGE MEDICAL GROUP LLC is a primary care clinic center in Columbia, SC. CONCIERGE MEDICAL GROUP LLC NPI is 1811407521. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

110 WILDEWOOD PARK DR STE A
COLUMBIA, SC
ZIP 29223-301
Phone: (803) 722-4988
Fax: (803) 656-8135

The provider's authorized official is Sarah Doctor-greenwade .
The authorized official title is Ceo and has the following contact phone number (803) 722-4988.

The CLIA number assigned to this NPI record is 42D2154656 - mobile laboratory with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/8/2017 and was last updated on 5/30/2024.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal MedicineNo
2261QP2300XClinic/CenterPrimary CareYes

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: 3/30/2025

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