NPIMap

Individual provider Active NPI

Lacey Taylor Hinson, PA

  • Physician Assistant
  • Columbia, SC
National Provider Identifier
1225586399
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2649 Issued in SC
Practice address
2 Medical Park Rd Ste 300
Columbia, SC 29203-6839
Phone
(803) 434-8800
Fax
(803) 434-8802
NPI assigned
Sep 16, 2016
Last updated
Jun 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2649 SC Primary

Addresses

Primary practice location

2 Medical Park Rd Ste 300
Columbia, SC 29203-6839

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other identifiers 1

IdentifierTypeStateIssuer
2816PAMedicaidSC

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
I20170330000858 SC Practitioner - Physician Assistant 9931484177 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

11 Richland Medical Park Dr
Columbia, SC 29203-6863
Phone (803) 434-4506

2 Medical Park Rd
Suite 506
Columbia, SC 29203-6876
Phone (803) 540-1000

7 Richland Medical Park Dr
Columbia, SC 29203-6863

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2649SCMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington Health Inc CurrentSince Feb 1, 2022 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Mar 13, 2018 Accepting new patients
Lexington Health Inc CurrentSince Feb 1, 2022 Accepting new patients
Prisma Health Medical Group-Midlands Past Accepting new patients

Locations

2 Medical Park Rd
Ste 300
Columbia, SC 29203
Phone (803) 434-8800

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

9 Richland Medical Park Dr
Ste 450
Columbia, SC 29203
Phone (803) 434-8800

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

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

146 E Hospital Dr
Ste 400
West Columbia, SC 29169
Phone (803) 936-3300

Interoperability endpoints

  • Direct secure messaging: lhumphries380549@direct.ghs.myhfn.org

Organizations & group practices 7

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 7

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": "1473984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1225586399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MEDICAL PARK RD STE 300",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036839",
            "telephone_number": "803-434-8800",
            "fax_number": "803-434-8802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINSON",
        "first_name": "LACEY",
        "middle_name": "TAYLOR",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-16",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2816PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.