Healthcare Provider Details

I. General information

NPI: 1275444028
Provider Name (Legal Business Name): KATHY WHORMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2026
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1235 JOHNSON AVE
COLUMBIA SC
29203-5859
US

IV. Provider business mailing address

945 LAKE MURRAY BLVD STE D26
IRMO SC
29063-2949
US

V. Phone/Fax

Practice location:
  • Phone: 305-939-6420
  • Fax:
Mailing address:
  • Phone: 305-939-6420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: