Vicki Lynn Landis, WHNP-BC

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

27377 Issued in SC

Practice address

333 Revolutionary TRL
Fairfax, SC 29827-7109

Phone

(803) 632-2533

Fax

(803) 632-3285

NPI assigned

Mar 19, 2013

Last updated

Jan 11, 2024By the provider in NPPES

Sex

Female

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 3

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Low Country Health Care System IncGroup PAC ID 4284530940, 33 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Allendale County Hospital Hospital, Fairfax, SC, CCN 421300

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Low Country Health Care System, Inc

  dba Low Country Health Care System

  • Federally Qualified Health Center (FQHC)
  • Farifax, SC
  • NPI 1053475566
  Medicare reassignment Care Compare group NPD
• Low Country Health Care System, Inc

  • Federally Qualified Health Center (FQHC)
  • Fairfax, SC
  • NPI 1649366022
  NPD
• Low Country Health Care System, Inc.

  dba Aiken Family Medicine

  • Federally Qualified Health Center (FQHC)
  • Aiken, SC
  • NPI 1194288571
  NPD
• Low Country Health Care System, Inc.

  dba Family Medical Center of Blackville

  • Federally Qualified Health Center (FQHC)
  • Blackville, SC
  • NPI 1235225608
  NPD
• Low Country Health Care System, Inc

  dba Barnwell Pediatrics

  • Federally Qualified Health Center (FQHC)
  • Barnwell, SC
  • NPI 1962442244
  NPD (past)
• Pediatrix Medical Group of Texas Billing, Inc.

  • Neonatal-Perinatal Medicine Physician
  • Houston, TX
  • NPI 1649377359
  NPD (past)

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

• Allendale County Hospital Board

  dba Allendale County Hospital

  • General Acute Care Hospital
  • Fairfax, SC
  • NPI 1609866912
  Care Compare affiliation

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

{
    "created_epoch": "1363651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1194067066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 WREN ST",
            "city": "BARNWELL",
            "state": "SC",
            "postal_code": "298121529",
            "telephone_number": "803-259-5762",
            "fax_number": "803-259-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 REVOLUTIONARY TRL",
            "city": "FAIRFAX",
            "state": "SC",
            "postal_code": "298277109",
            "telephone_number": "803-632-2533",
            "fax_number": "803-632-3285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDIS",
        "first_name": "VICKI",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-19",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "SC",
            "license": "27377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP9418",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "SCP955",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "27377",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Honest Way Transportation LLC
• Charles Taylor Hudson
• Robert M Jones, MD
• Walter R Kirby, PA-C
• Mol Ky, DO
• Low Country Health Care System, Inc
• Shenika L. Marshall-Hill
• Janet M McKissick, MD
• Baxter McLendon, M.D.
• Myecha Lashawn Miley

• Women's Health Nurse Practitioner in Fairfax, SC
• Providers in Fairfax, SC by specialty
• Women's Health Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; 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.
• 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.