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

Providence Physician Practices LLC

Organization Family Medicine Physician · NPI 1558710376

Providence Physician Practices LLC is a Family Medicine Physician in Irmo, South Carolina. Registered with an NPI since 2016.

In the registry since
2016
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

7936 Broad River Rd
Irmo, SC 29063-2355
Phone: (803) 732-4001
Fax: (803) 732-2123
Show map & directions

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

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Family Medicine Physician Taxonomy 207Q00000X

Record details

NPI number1558710376
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jess Judy — President · (615) 920-7000
Other names Three Rivers Medical Associates
NPI enumeratedJune 13, 2016
Last updated in NPPESFebruary 23, 2017
Mailing address114 Gateway Corporate Blvd, Ste 425, Columbia, SC 29203-9740

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