COLUMBIA MEDICAL GROUP
NPI 1174506497
Internal Medicine in Columbia, SC

Active since November 21, 2005CLIA Certified · 2 labs
4540 TRENHOLM RD, COLUMBIA, SC 29206(803) 790-4700(803) 790-6130 Get Directions Write a Review

NPPES record last updated: October 16, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Columbia Medical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COLUMBIA MEDICAL GROUP (NPI 1174506497) is a healthcare organization registered as an internal medicine in Columbia, South Carolina and active in the NPI registry since November 2005. The organization holds 2 active CLIA laboratory certificates and lists David William Gavin, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1174506497
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCOLUMBIA MEDICAL GROUP
Location Address4540 TRENHOLM RDColumbia, SC 29206-4462
Mailing Address4540 Trenholm RdColumbia, SC 29206-4462 · (803) 790-4700 · Fax (803) 790-6130
Fax(803) 790-6130
Organization SubpartNo
Authorized OfficialDavid William GavinOffice Manager · (803) 790-4700
Enumeration DateNovember 21, 2005
Last NPPES UpdateOctober 16, 2007
NPI 1174506497 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in SC · 14628
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

4540 TRENHOLM RD, Columbia, SC 29206

Other Identifiers 9

Medicare UPIN6742SC
Medicare UPING08050SC
Medicare UPINE12474SC
Medicare UPINC60872SC
Medicare UPIND17897SC
MedicaidGP2807SC
Medicare UPING78207SC
Medicare UPINB91630SC
Medicare UPING04724SC

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 42D0249357

Columbia Medical Group, The · Columbia, SC
Active · expires Dec 22, 2027
CLIA Number42D0249357
Laboratory TypePhysician Office
Certificate Effective DateDecember 23, 2025
Certificate Expiration DateDecember 22, 2027
Laboratory DirectorDr. Ruben Mayer
Laboratory Phone(803) 790-4700
Laboratory LocationColumbia Medical Group, The4540 Trenholm Rd, Columbia, SC 29206
CLIA data matches this NPI record on: Address Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Waiver 42D2327357

Columbia Medical Group Forest Drive · Columbia, SC
Active · expires Jul 21, 2027
CLIA Number42D2327357
Laboratory TypePhysician Office
Certificate Effective DateJuly 22, 2025
Certificate Expiration DateJuly 21, 2027
Laboratory DirectorMatthew P. Mazzola
Laboratory Phone(803) 790-4700
Laboratory LocationColumbia Medical Group Forest Drive5115 Forest Drive Suite 100, Columbia, SC 29206
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine
4540 TRENHOLM RD
COLUMBIA, SC 29206
Internal Medicine
4540 TRENHOLM RD
COLUMBIA, SC 29206
Internal Medicine
4540 TRENHOLM RD
COLUMBIA, SC 29206
Internal Medicine
4540 TRENHOLM RD
COLUMBIA, SC 29206
Internal Medicine
4540 TRENHOLM RD
COLUMBIA, SC 29206
Nurse Practitioner (Primary Care)
4540 TRENHOLM RD
COLUMBIA, SC 29206
Nurse Practitioner
4540 TRENHOLM RD
COLUMBIA, SC 29206
Internal Medicine
4540 TRENHOLM RD
COLUMBIA, SC 29206

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Columbia Medical Group's NPI number?

The NPI number for Columbia Medical Group is 1174506497. It was assigned to this organization in the NPPES registry on November 21, 2005.

Where is Columbia Medical Group located?

Columbia Medical Group is located at 4540 Trenholm Rd, Columbia, SC 29206. The listed phone number is (803) 790-4700.

What is Columbia Medical Group's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Columbia Medical Group hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Columbia Medical Group was last updated on October 16, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.