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

Northlake Family Medical Practice

Organization Family Medicine Physician · NPI 1003928680

Northlake Family Medical Practice is a Family Medicine Physician in Columbia, South Carolina. Licensed in South Carolina. Registered with an NPI since 2006.

Licensed in
SC
In the registry since
2006

Practice location Address checks out

3000 NE Medical Park Ste 101
Columbia, SC 29223-6251
Phone: (803) 419-5131
Fax: (803) 419-5130
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 14862 (SC)

Record details

NPI number1003928680
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Reginald Parker — Owner · (803) 419-5131
NPI enumeratedAugust 31, 2006
Last updated in NPPESOctober 16, 2007
Mailing address3000 Ne Medical Park, Ste 101, Columbia, SC 29223-6251

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