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Providence Physician Practices LLC

Internal Medicine Physician in Kershaw, SC · enumerated 2019 · authorized official Kathy Teague, Corporate Secretary.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1659921740

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Registry record

Entity type Organization (Type 2)
Legal business name Providence Physician Practices LLC
Practice address 216 E Marion St, Kershaw, SC, 29067
Phone (803) 475-3350
Fax (803) 475-5360
Enumeration date Sep 19, 2019
Last updated in NPPES Dec 9, 2019

Taxonomy & classification

152W00000X Optometrist Eye and Vision Services Providers Secondary
207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians Secondary
207R00000X Internal Medicine Physician Allopathic & Osteopathic Physicians Primary
207RC0000X Cardiovascular Disease Physician Allopathic & Osteopathic Physicians Secondary
207RE0101X Endocrinology, Diabetes & Metabolism Physician Allopathic & Osteopathic Physicians Secondary
207V00000X Obstetrics & Gynecology Physician Allopathic & Osteopathic Physicians Secondary
207W00000X Ophthalmology Physician Allopathic & Osteopathic Physicians Secondary
208000000X Pediatrics Physician Allopathic & Osteopathic Physicians Secondary
363LG0600X Gerontology Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Secondary

Authorized official

Name Kathy Teague
Title Corporate Secretary
Phone (615) 920-7646

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Where is Providence Physician Practices LLC located?
The practice location on file with NPPES is in Kershaw, SC.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2019-12-09. Verify at npiregistry.cms.hhs.gov.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2019-12-09.