NPIMap

Individual provider Active NPI

Michael L Nunnery, MD

  • Family Medicine Physician
  • Irmo, SC
National Provider Identifier
1194736512
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
23614 Issued in SC
Practice address
1846 Dutch Fork Rd
Irmo, SC 29063
Phone
(803) 781-5200
Fax
(803) 781-3843
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 23614 SC Primary

Addresses

Primary practice location

1846 Dutch Fork Rd
Irmo, SC 29063

Mailing address

PO Box 6069
West Columbia, SC 29171-6069

Other practice location 1

76 Polo Rd
Columbia, SC 29223-2806
Phone (803) 699-0848

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mnunnery14749@direct.lexmed.com

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
I20040702000483 SC Practitioner - Family Practice 6204813652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Carolina School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lexington Health IncGroup PAC ID 2567872070, 905 clinicians

Practice addresses (Care Compare)

1846 Dutch Fork Rd
Irmo, SC 29063-8830
Phone (803) 314-9640

557 Columbia Ave
Chapin, SC 29036-8324

565 Columbia Ave
Chapin, SC 29036-8324

76 Polo Rd
Columbia, SC 29223-2806
Phone (803) 699-7255

811 W Main St
Lexington, SC 29072-2500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.09 of 100Reported as group
Quality
68.87
Promoting interoperability
100
Improvement activities
40
Cost
78.11

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23614SCMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington County Health Services District Inc Current Accepting new patients
Lexington Health Inc CurrentSince Feb 1, 2021 Accepting new patients
Lexington Health Inc Family Medicine CurrentSince Feb 1, 2021 Accepting new patients
Lexington Health Inc Family Medicine Current Accepting new patients
Lexington County Health Serv Family Medicine Past Accepting new patients
Lexington County Health Services District, Inc. Past Accepting new patients

Locations

7037 Saint Andrews Rd
Columbia, SC 29212
Phone (803) 732-0963

7035 Saint Andrews Rd
Columbia, SC 29212
Phone (803) 749-0924

76 Polo Rd
Columbia, SC 29223
Phone (803) 699-7255

1846 Dutch Fork Rd
Irmo, SC 29063
Phone (803) 314-9640

122 Powell Dr
Lexington, SC 29072
Phone (803) 957-8400

811 W Main St
Ste 101
Lexington, SC 29072
Phone (803) 936-7230

5535 Platt Springs Rd
Lexington, SC 29073
Phone (803) 314-9510

2006 Augusta Hwy
Lexington, SC 29072
Phone (803) 358-6400

3314 Platt Springs Rd
West Columbia, SC 29170
Phone (803) 791-3494

Interoperability endpoints

  • Direct secure messaging: mnunnery14749@direct.lexmed.com

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 and National Provider Directory roles.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1194736512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6069",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291716069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1846 DUTCH FORK RD",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "29063",
            "telephone_number": "803-781-5200",
            "fax_number": "803-781-3843"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "76 Polo Rd",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292232806",
            "country_code": "US",
            "telephone_number": "803-699-0848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NUNNERY",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "23614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mnunnery14749@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "1846 Dutch Fork Rd",
            "city": "Irmo",
            "state": "SC",
            "country_code": "US",
            "postal_code": "29063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Irmo, SC

Sources for this page

Verify at the official NPI Registry.