NPIMap

Individual provider Active NPI

Keith Woodward Lackey, MD

  • Internal Medicine Physician
  • Charleston, SC
National Provider Identifier
1154389815
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
15543 Issued in SC
Practice address
615 Wesley Drive
Suite 300
Charleston, SC 29407
Phone
(843) 266-4400
Fax
(843) 577-0455
NPI assigned
May 3, 2006
Last updated
Apr 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 15543 SC Primary

Addresses

Primary practice location

615 Wesley Drive
Suite 300
Charleston, SC 29407

Mailing address

PO Box 751649
Charlotte, NC 28275-1649
Phone (888) 472-0043

Other identifiers 4

IdentifierTypeStateIssuer
110105130OtherSCRR MEDICARE
155432MedicaidSC
110232037OtherSCRR MEDICARE
P00754364OtherSCRAILROAD MC ID-RSFPN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Keith.Lackey@rsfpp.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090603000516 SC Practitioner - Internal Medicine 7911057401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical University of South Carolina College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2075 Eagle Landing Blvd
N Charleston, SC 29406-4074
Phone (843) 789-1800

615 Wesley Dr
Charleston, SC 29407-7274

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15543SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Saint Francis Physicians Network Current Accepting new patients
Roper Saint Francis Physicians Network CurrentSince May 11, 2009 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince May 11, 2009 Accepting new patients
Roper Saint Francis Physicians Network Internal Medicine Past Accepting new patients
Roper Saint Francis Physicians Network Internal Medicine Past Accepting new patients
Lowcountry Medical Associates Internal Medicine Past Accepting new patients

Locations

1 S Park Cir
Ste 400
Charleston, SC 29407
Phone (843) 789-1651

615 Wesley Dr
Ste 120
Charleston, SC 29407
Phone (843) 266-0900

615 Wesley Dr
Ste 300
Charleston, SC 29407
Phone (843) 266-4400

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

Interoperability endpoints

  • Direct secure messaging: keith.lackey@rsfpp.eclinicaldirectplus.com
  • Direct secure messaging: klackey1235948@direct.bsmhealth.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1154389815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "888-472-0043",
            "fax_number": "843-724-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 WESLEY DRIVE",
            "address_2": "SUITE 300",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29407",
            "telephone_number": "843-266-4400",
            "fax_number": "843-577-0455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKEY",
        "first_name": "KEITH",
        "middle_name": "WOODWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "15543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110105130",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155432",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110232037",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MC ID-RSFPN",
            "identifier": "P00754364",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Keith.Lackey@rsfpp.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Patient Care Documents",
            "address_1": "615 Wesley Drive",
            "address_2": "Suite 300",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "29407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.