Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Colonial Family Practice & Ambulatory Care Center

Organization Emergency Medicine Physician · NPI 1902229214

Colonial Family Practice & Ambulatory Care Center is an Emergency Medicine Physician in Columbia, South Carolina. Licensed in South Carolina. Registered with an NPI since 2014.

Licensed in
SC
In the registry since
2014
Specialties on file
8
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Practice location Address checks out

4700 Forest Dr
Columbia, SC 29206
Phone: (803) 773-5227
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 25518 (SC)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 28747 (SC)
Endoscopy Clinic/Center Taxonomy 261QE0800X · Licence 17676 (SC)
Health Service Clinic/Center Taxonomy 261QH0100X
Magnetic Resonance Imaging (MRI) Clinic/Center Taxonomy 261QM1200X · Licence 07-6916 GLENN GOUDY (SC)
Physician Assistant Taxonomy 363A00000X
Nurse Practitioner Taxonomy 363L00000X
Family Nurse Practitioner Taxonomy 363LF0000X

Record details

NPI number1902229214
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationColonial Family Practice, LLC
Authorized official Stephanie Disher — Credentialing Manager · (803) 773-5227
Other names Colonial Family Practice Columbia
NPI enumeratedJanuary 23, 2014
Last updated in NPPESMarch 22, 2021
Certification dateMarch 22, 2021
Mailing address325 Broad St, Suite 100, Sumter, SC 29150-4167

Other providers in Columbia