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Contact Information

COMMUNITY WELLNESS GROUP LLC
2430 ATLAS RD STE 1
COLUMBIA, SC29209-3625
 Phone: 803-586-1752
 Fax: 877-995-5934
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Addiction (Substance Use Disorder)

101YA0400X
 

Addiction Medicine

2083A0300X 84 Physician/Preventive Medicine
 

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
 

Chiropractor

111N00000X 35 Chiropractic
 

Mental Health

101YM0800X
 

Professional

101YP2500X
 

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for COMMUNITY WELLNESS GROUP LLC

NPI # 1982144606
LBN Legal business name COMMUNITY WELLNESS GROUP LLC
Authorized official KENNETH SIMMONS - (DIRECTOR/MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/28/2017
Last updated 12/07/2021 - About 4 years ago
Identifiers
SC Medicaid GP8968
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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