NPIMap

Individual provider Active NPI

James Lipke, MD

  • Family Medicine Physician
  • Charleston, SC
National Provider Identifier
1265476923
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
15067 Issued in SC
Practice address
418 Folly Rd Ste a
Charleston, SC 29412-2625
Phone
(843) 795-5362
NPI assigned
Jun 15, 2006
Last updated
May 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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 15067 SC Primary

Addresses

Primary practice location

418 Folly Rd Ste a
Charleston, SC 29412-2625

Mailing address

1818 Henderson St
Columbia, SC 29201-2619
Phone (803) 758-2600

Other identifiers 2

IdentifierTypeStateIssuer
150678MedicaidSC
SC0365A634OtherSCMEDICARE PTAN

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
I20061109000086 SC Practitioner - Family Practice 5597762369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Florida College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Liberty Doctors LLCGroup PAC ID 0840466017, 44 clinicians

Practice addresses (Care Compare)

418 Folly Rd
Ab
Charleston, SC 29412-2625
Phone (843) 225-8320

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15067SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty Doctors, LLC Family Medicine CurrentSince Jan 1, 2023 Accepting new patients
Liberty Doctors LLC Family Medicine CurrentSince Jan 1, 2023 Accepting new patients
Liberty Doctors LLC Past Accepting new patients
Lowcountry Medical Associates Family Medicine Past Accepting new patients
Lowcountry Medical Associates Past Accepting new patients

Locations

1064 Gardner Rd
Ste 216
Charleston, SC 29407
Phone (843) 266-0909

418 Folly Rd
#A
Charleston, SC 29412
Phone (843) 225-8320

Interoperability endpoints

  • Direct secure messaging: jlipke@libertydoctors.ssdirect.aprima.com

Organizations & group practices 5

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 6

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1265476923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 HENDERSON ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012619",
            "telephone_number": "803-758-2600",
            "fax_number": "803-253-8896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 FOLLY RD STE A",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294122625",
            "telephone_number": "843-795-5362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPKE",
        "first_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "15067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150678",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "SC0365A634",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.