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

Northlake Family Practice

Organization Exclusive Provider Organization · NPI 1336684851

Northlake Family Practice is an Exclusive Provider Organization in Columbia, South Carolina. Licensed in South Carolina. Registered with an NPI since 2016.

Licensed in
SC
In the registry since
2016

Practice location Address checks out

115 Blarney Dr Ste 101 C
Columbia, SC 29223-6291
Phone: (803) 419-5131
Show map & directions

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

Specialties & licences

Exclusive Provider Organization (primary) Taxonomy 302F00000X · Licence 19001 (SC)

Record details

NPI number1336684851
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Robert Ramos — President / Owner · (803) 622-3559
NPI enumeratedDecember 20, 2016
Last updated in NPPESDecember 20, 2016
Mailing address115 Blarney Dr, Suite 101 C, Columbia, SC 29223-6291

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