Individual provider Active NPI

Lola B Clarkson, MD

  • Clinical Genetics (M.D.) Physician
  • Columbia, SC
National Provider Identifier
1184615825
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X
License
13601 Issued in SC
Practice address
1911 Thurmond Mall
Columbia, SC 29201-2375
Phone
(803) 799-5390
Fax
(803) 799-5391
NPI assigned
Nov 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Genetics (M.D.) Physician 207SG0201X 13601 SC Primary

Addresses

Primary practice location

1911 Thurmond Mall
Columbia, SC 29201-2375

Mailing address

101 Gregor Mendel Cir
Greenwood, SC 29646-2316
Phone (864) 941-8100

Other identifiers 1

IdentifierTypeStateIssuer
136016MedicaidSC

Other names 1

  • Dr. Lola K Clarkson Other name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130129000300 SC Practitioner - Pediatric Medicine 6901070010 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Greenwood Genetic Center Lab CurrentSince Oct 1, 2000 Accepting new patients
Greenwood Genetics Center, Inc. Clinical Genetics (M.D.) Current Accepting new patients
Greenwood Genetics Center, Inc. Clinical Genetics (M.D.) CurrentSince Oct 1, 2000 Accepting new patients

Locations

1911 Thurmond Mall
Columbia, SC 29201
Phone (803) 356-6854

101 Gregor Mendel Cir
Greenwood, SC 29646
Phone (864) 941-8100

Interoperability endpoints

  • Direct secure messaging: lclarkson473657@direct.musc.edu

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1184615825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 GREGOR MENDEL CIR",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296462316",
            "telephone_number": "864-941-8100",
            "fax_number": "864-941-8114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 THURMOND MALL",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012375",
            "telephone_number": "803-799-5390",
            "fax_number": "803-799-5391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKSON",
        "first_name": "LOLA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "SC",
            "license": "13601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136016",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOLA",
            "last_name": "CLARKSON",
            "middle_name": "K",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.