Lake City Medical Associates 2017, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

LAKE CITY MEDICAL ASSOCIATES 2017, LLC

Practice address

130 S Acline St
Lake City, SC 29560-2633

Phone

(843) 374-3277

Fax

(843) 374-3281

NPI assigned

Jun 15, 2017

Last updated

Mar 2, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sheila P Godwin

Title

Office Manager

Phone

(843) 374-3277

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519948800000",
    "number": "1316477060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 S ACLINE ST",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295602633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S ACLINE ST",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295602633",
            "telephone_number": "843-374-3277",
            "fax_number": "843-374-3281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CITY MEDICAL ASSOCIATES 2017, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-15",
        "last_updated": "2018-03-02",
        "status": "A",
        "authorized_official_last_name": "GODWIN",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "843-374-3277"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake City Diagnostic Imaging, Inc. (Lake City Diagnostic Imaging)
• Lake City Family Dentistry
• Lake City Family Dentistry
• Lake City Family Medicine LLC
• Lake City Family Medicine LLC
• Lake City Orthopaedic Clinic
• Lakeside Medical Response
• Benjamin Wade Lamb, M.D.
• Erin Lewis, FNP
• Pamela Lewis, FNP-C

• Primary Care Clinic/Center in Lake City, SC
• Providers in Lake City, SC by specialty
• Primary Care Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.