Organization Active NPI

Lung and Chest Medical Associates, LLC

  • Family Nurse Practitioner
  • Spartanburg, SC
National Provider Identifier
1326284340
Registry record updated Jun 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2972 Issued in SC
Legal business name
LUNG AND CHEST MEDICAL ASSOCIATES, LLC
Practice address
2030 North Church Place
Spartanburg, SC 29303-2799
Phone
(864) 528-6858
Fax
(864) 585-0999
NPI assigned
Dec 22, 2008
Last updated
Jun 11, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2009

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

Authorized official

Name
Dr. Wilson P Smith Jr., M.D.
Title
Partner
Phone
(864) 582-6858

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2972 SC Primary

Addresses

Primary practice location

2030 North Church Place
Spartanburg, SC 29303-2799

Mailing address

2030 North Church Place
Spartanburg, SC 29303-2799
Phone (864) 528-6858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090324000697 SC Part B Supplier - Clinic/Group Practice 8628135308 Receives reassigned benefits from 4 practitioners
Practice locations: Greer, SC; Spartanburg, SC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1229904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244678400000",
    "number": "1326284340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 NORTH CHURCH PLACE",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293032799",
            "telephone_number": "864-528-6858",
            "fax_number": "864-585-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 NORTH CHURCH PLACE",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293032799",
            "telephone_number": "864-528-6858",
            "fax_number": "864-585-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUNG AND CHEST MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-22",
        "last_updated": "2009-06-11",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "WILSON",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "864-582-6858",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "2972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.