Organization Active NPI

Lakeside Family Medicine, PA

  • Family Medicine Physician
  • Anderson, SC
National Provider Identifier
1073562864
Registry record updated Nov 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LAKESIDE FAMILY MEDICINE, PA
Practice address
4120 Highway 24
Anderson, SC 29626-5321
Phone
(864) 224-4003
Fax
(864) 224-4999
NPI assigned
May 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2008

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

Authorized official

Name
Melody Franks, MD
Title
MD
Phone
(864) 224-4003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

4120 Highway 24
Anderson, SC 29626-5321

Mailing address

4120 Highway 24
Anderson, SC 29626-5321
Phone (864) 224-4003

Other identifiers 1

IdentifierTypeStateIssuer
GP2512MedicaidSC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225929600000",
    "number": "1073562864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4120 HIGHWAY 24",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296265321",
            "telephone_number": "864-224-4003",
            "fax_number": "864-224-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 HIGHWAY 24",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296265321",
            "telephone_number": "864-224-4003",
            "fax_number": "864-224-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE FAMILY MEDICINE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2008-11-06",
        "status": "A",
        "authorized_official_last_name": "FRANKS",
        "authorized_official_first_name": "MELODY",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "864-224-4003",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2512",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.