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Colonial Family Practice & Ambulatory Care Center

Family Medicine Physician in Columbia, SC · enumerated 2014 · authorized official Stephanie Disher, Credentialing Manager.

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

National Provider Identifier

1902229214

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Registry record

Entity type Organization (Type 2)
Legal business name Colonial Family Practice & Ambulatory Care Center
Other name <Unavail>
Parent organization Colonial Family Practice, LLC
Practice address 4700 Forest Dr, Columbia, SC, 29206
Phone (803) 773-5227
Enumeration date Jan 23, 2014
Last updated in NPPES Mar 22, 2021

Taxonomy & classification

207P00000X Emergency Medicine Physician Allopathic & Osteopathic Physicians · License 28747 (SC) Secondary
207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians · License 25518 (SC) Primary
261QE0800X Endoscopy Clinic/Center Ambulatory Health Care Facilities · License 17676 (SC) Secondary
261QH0100X Health Service Clinic/Center Ambulatory Health Care Facilities Secondary
261QM1200X Magnetic Resonance Imaging (MRI) Clinic/Center Ambulatory Health Care Facilities · License 07-6916 GLENN GOUDY (SC) Secondary
363A00000X Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Secondary
363L00000X Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Secondary
363LF0000X Family Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Secondary

Authorized official

Name Stephanie Disher
Title Credentialing Manager
Phone (803) 773-5227

Other identifiers

Identifier Type State Issuer
GP3564 Medicaid SC -

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

What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.
What type of organization is Colonial Family Practice & Ambulatory Care Center?
Colonial Family Practice & Ambulatory Care Center is registered in NPPES as a Family Medicine Physician (its primary provider taxonomy).

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2021-03-22.