1. Home
  2. Directory
  3. South Carolina
  4. Columbia
  5. Family Medicine
  6. NPI Profile

BULL ST. DISTRICT FAMILY PRACTICE LLC
NPI 1265232326
Family Medicine - Adult Medicine in Columbia, SC

Active since March 18, 2025
1417 GREGG ST, COLUMBIA, SC 29201(803) 915-0469 Get Directions Write a Review

NPPES record last updated: March 18, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Bull St. District Family Practice Llc NPPES

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

BULL ST. DISTRICT FAMILY PRACTICE LLC (NPI 1265232326), doing business as Bull St District Family Practice, is a healthcare organization registered as an adult medicine in Columbia, South Carolina and active in the NPI registry since March 2025. The organization lists Cornell Maurice Clark, Managing Director, as its authorized official.

NPPES Registry Identity

NPI1265232326
Entity TypeOrganization
Primary Taxonomy207QA0505X
Legal Business NameBULL ST. DISTRICT FAMILY PRACTICE LLC
Location Address1417 GREGG STColumbia, SC 29201-3527
Mailing AddressPo Box 99Columbia, SC 29202-0099 · (803) 915-0469
Phone(803) 915-0469
Organization SubpartNo
Authorized OfficialCornell Maurice ClarkManaging Director · (702) 904-4077
Enumeration DateMarch 18, 2025
NPPES CertifiedMarch 18, 2025
✔ NPI 1265232326 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0505X
Definition

The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.

1417 GREGG ST, Columbia, SC 29201
Open in Google Maps ↗

Other Names 2

Doing Business AsBull St District Family Practice
Doing Business AsCornell M. Clark, M.d.

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

Other Providers at the Same Location NPPES 4

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

LISA OLIVER NUTRITION THERAPIST
Nutritionist (Nutrition, Education)
1417 GREGG ST, SUITE1
COLUMBIA, SC 29201
Richland County (888) 238-4078
CONNECTING HEALTH INNOVATIONS LLC
Dietitian, Registered
1417 GREGG ST
COLUMBIA, SC 29201
Richland County (803) 714-3311
JOYECE ANDERSON ABD, MSW, LMSW
Social Worker (Clinical)
1417 GREGG ST
COLUMBIA, SC 29201
Richland County (803) 758-2445
NEW BEGINNINGS RECOVERY CENTER LLC
Community/Behavioral Health
1417 GREGG ST
COLUMBIA, SC 29201
Richland County (803) 758-2445

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 Bull St. District Family Practice LLC's NPI number?

The NPI number for Bull St. District Family Practice LLC is 1265232326. It was assigned to this organization in the NPPES registry on March 18, 2025. The provider is doing business as Bull St District Family Practice and Cornell M. Clark, M.D..

Where is Bull St. District Family Practice LLC located?

Bull St. District Family Practice LLC is located at 1417 Gregg St, Columbia, SC 29201. The listed phone number is (803) 915-0469.

What is Bull St. District Family Practice LLC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

When was this NPI record last updated?

The NPPES record for Bull St. District Family Practice LLC was last updated on March 18, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.