Live Oak Medical Center, PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

9352 Issued in SC

Legal business name

LIVE OAK MEDICAL CENTER, PA

Practice address

342 W Main St
Kingstree, SC 29556-3235

Phone

(843) 355-3621

NPI assigned

May 20, 2009

Organization subpart

Yes

Parent organization

LIVE OAK MEDICAL CENTER, PAAs reported in NPPES

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

Authorized official

Name

Albert Durant Mims, M.D.

Title

Director

Phone

(843) 687-0435

Specialties & licenses 1

Addresses

Part of

Live Oak Medical Center PA

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Benjamin Wade Lamb, M.D.

  • Family Medicine Physician
  • Lake City, SC
  • NPI 1003912775
  NPD (past)

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

{
    "created_epoch": "1242777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278633600000",
    "number": "1235364282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 W MAIN ST",
            "city": "KINGSTREE",
            "state": "SC",
            "postal_code": "295563235",
            "telephone_number": "843-687-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 W MAIN ST",
            "city": "KINGSTREE",
            "state": "SC",
            "postal_code": "295563235",
            "telephone_number": "843-355-3621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE OAK MEDICAL CENTER, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIVE OAK MEDICAL CENTER, PA",
        "enumeration_date": "2009-05-20",
        "last_updated": "2010-07-09",
        "status": "A",
        "authorized_official_last_name": "MIMS",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "DURANT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "843-687-0435",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "9352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake City Family Medicine, LLC
• Jennifer Moore Lamb, RN, BSN
• Karlie Michael Lambert, PTA
• Ariane U Lieberman, M.D.
• Craig Lieberman, M.D.
• Live Oak Medical Center, PA
• Joann Conyers Lockhart
• Lovely Doves LLC
• Lucius F Wates DMD PA
• Allissa Deashia Matthews

• Family Medicine Physician in Kingstree, SC
• Providers in Kingstree, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.