Individual provider Active NPI

Lawrence E Stroud Jr., MD

  • Cardiovascular Disease Physician
  • Pendleton, SC
National Provider Identifier
1316933559
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
9099 Issued in SC
Practice address
2229 Old Greenville Hwy
Pendleton, SC 29670
Phone
(864) 855-1036
NPI assigned
Sep 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 9099 SC Primary

Addresses

Primary practice location

2229 Old Greenville Hwy
Pendleton, SC 29670

Mailing address

2229 Old Greenville Hwy
Pendleton, SC 29670-9206
Phone (864) 646-9517

Other identifiers 5

IdentifierTypeStateIssuer
57-0739752OtherSCCORP. FEDERAL ID NUMBER
110048374OtherSCRAILROAD MEDICARE PROV NO
42D0252876OtherSCCLIA NUMBER
090993MedicaidSC
PA4726OtherSCGROUP MEDICAID NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9099SCMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fleetwood Internal Medicine PA Cardiovascular Disease CurrentSince Nov 1, 1978 Accepting new patients

Locations

109 Fleetwood Dr
#B
Easley, SC 29640
Phone (864) 522-3970

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1316933559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2229 OLD GREENVILLE HWY",
            "city": "PENDLETON",
            "state": "SC",
            "postal_code": "296709206",
            "telephone_number": "864-646-9517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2229 OLD GREENVILLE HWY",
            "city": "PENDLETON",
            "state": "SC",
            "postal_code": "29670",
            "telephone_number": "864-855-1036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STROUD",
        "first_name": "LAWRENCE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "SC",
            "license": "9099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORP. FEDERAL ID NUMBER",
            "identifier": "57-0739752",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROV NO",
            "identifier": "110048374",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA NUMBER",
            "identifier": "42D0252876",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "090993",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID NUMBER",
            "identifier": "PA4726",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pendleton, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; 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.