NPIMap

Organization Active NPI

Upstate Lung and Critical Care Specialists PC

  • Pulmonary Disease Physician
  • Spartanburg, SC
National Provider Identifier
1013963982
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
UPSTATE LUNG AND CRITICAL CARE SPECIALISTS PC
Practice address
151 Harold Fleming CT
Spartanburg, SC 29303-4225
Phone
(864) 208-0347
Fax
(864) 573-6323
NPI assigned
May 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lashanda Mayberry
Title
Credential Coordinator
Phone
(864) 573-6320

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

151 Harold Fleming CT
Spartanburg, SC 29303-4225

Mailing address

151 Harold Fleming CT
Spartanburg, SC 29303-4225
Phone (864) 573-6320

Other identifiers 2

IdentifierTypeStateIssuer
890729MMedicaidNC
GP3212MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041011000276 SC Part B Supplier - Clinic/Group Practice 7719946185 Receives reassigned benefits from 11 practitioners
9 other NPIs on this enrollment
Practice locations: Gaffney, SC; Spartanburg, SC; Union, SC

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D0981457Upstate Lung & Critical Care Specialists151 Harold Fleming Court, Spartanburg, SC 29303Certificate of waiverDec 27, 2026

National Provider Directory

National Provider Directory

Locations

1530 N Limestone St
Gaffney, SC 29340
Phone (864) 487-1544

1529 N Limestone St
#B
Gaffney, SC 29340

853 N Church St
Spartanburg, SC 29303
Phone (864) 560-6193

151 Harold Fleming Ct
Spartanburg, SC 29303
Phone 8645736320219

1005 Thompson Blvd
Ste C
Union, SC 29379

1005 Thompson Blvd
Union, SC 29379
Phone (864) 427-0278

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678838400000",
    "number": "1013963982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 HAROLD FLEMING CT",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293034225",
            "telephone_number": "864-573-6320",
            "fax_number": "864-573-6323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 HAROLD FLEMING CT",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293034225",
            "telephone_number": "864-208-0347",
            "fax_number": "864-573-6323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE LUNG AND CRITICAL CARE SPECIALISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A",
        "authorized_official_last_name": "MAYBERRY",
        "authorized_official_first_name": "LASHANDA",
        "authorized_official_title_or_position": "CREDENTIAL COORDINATOR",
        "authorized_official_telephone_number": "864-573-6320"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890729M",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3212",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.