Lance M Gowen, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

15208 Issued in NE

Practice address

515 Rivercrossing Dr Ste 180
Fort Mill, SC 29715-7900

Phone

(803) 547-7541

Fax

(803) 548-0122

NPI assigned

Feb 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1114999737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 N 10TH ST",
            "city": "BEATRICE",
            "state": "NE",
            "postal_code": "683102001",
            "telephone_number": "402-228-3436",
            "fax_number": "402-223-4515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 RIVERCROSSING DR STE 180",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297157900",
            "telephone_number": "803-547-7541",
            "fax_number": "803-548-0122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 N 10th St",
            "address_purpose": "LOCATION",
            "city": "Beatrice",
            "state": "NE",
            "postal_code": "683102001",
            "country_code": "US",
            "telephone_number": "402-228-3436",
            "fax_number": "402-223-4515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOWEN",
        "first_name": "LANCE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "15208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47065527613",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alina N/a Gomez
• Gonstead Chiropractic, PA
• Leslie Gooding, BACB740780
• Alexandra Goodman
• Shaena K Gore, RBT
• Zamia Grady
• Darlene Graham
• Sydney Elise Gray-McDonald
• Ebony Gray, BSW
• Kimberly Gray, RN

• Family Medicine Physician in Fort Mill, SC
• Providers in Fort Mill, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.