NPIMap

Organization Active NPI

Lower Florence County Hosptial

  • Surgery Physician
  • Lake City, SC
National Provider Identifier
1316449333
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
LOWER FLORENCE COUNTY HOSPTIAL
Practice address
324 Mercy St
Lake City, SC 29560-2332
Phone
(843) 374-9945
Fax
(843) 374-5699
NPI assigned
Mar 6, 2018
Organization subpart
Yes
Parent organization
LAKE CITY COMMUNITY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Mary D Stuckey
Title
Director
Phone
(843) 374-2036

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

324 Mercy St
Lake City, SC 29560-2332

Mailing address

PO Box 1479
Lake City, SC 29560-1479
Phone (843) 374-2036

Other identifiers 1

IdentifierTypeStateIssuer
084553MedicaidSC

Other names 1

  • Lake City Surgical Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lower Florence County Hosp7 organizations share this tax ID, including this one
Part of
Lower Florence County Hosp

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1520294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1316449333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1479",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295601479",
            "telephone_number": "843-374-2036",
            "fax_number": "843-374-5675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 MERCY ST",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295602332",
            "telephone_number": "843-374-9945",
            "fax_number": "843-374-5699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOWER FLORENCE COUNTY HOSPTIAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAKE CITY COMMUNITY HOSPITAL",
        "enumeration_date": "2018-03-06",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "STUCKEY",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "843-374-2036"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084553",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake City Surgical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake City, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.