Colonial Family Practice, LLC
NPI 1336725209 · Family Medicine Physician · Eastover, SC
Provider details
- NPI number
- 1336725209
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Colonial Family Practice, LLC
- Organization subpart
- Yes
- Authorized official
- Stephanie Disher, Credentialing Manager(803) 773-5227
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Physician Assistant363A00000X
Physician Assistants & Advanced Practice Nursing Providers
- Medical Physician Assistant363AM0700X
Physician Assistants & Advanced Practice Nursing Providers
- Nurse Practitioner363L00000X
Physician Assistants & Advanced Practice Nursing Providers
- Family Nurse Practitioner363LF0000X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Colonial Family Practice Garners Ferry
Registry dates
- Enumerated
- 2021-03-22
- Last updated
- 2021-03-22
- Certified
- 2021-03-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.