Individual provider Active NPI

Carey Lennon, PA-C

  • Surgical Physician Assistant
  • North Charleston, SC
National Provider Identifier
1336657428
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
4534 Issued in SC
Practice address
2880 Tricom St
North Charleston, SC 29406-9171
Phone
(843) 797-5050
Fax
(843) 797-3633
NPI assigned
Jan 11, 2018
Last updated
Aug 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 4534 SC Primary
Orthopaedic Surgery Physician 207X00000X 0010-07819 NC

Addresses

Primary practice location

2880 Tricom St
North Charleston, SC 29406-9171

Mailing address

2880 Tricom St
North Charleston, SC 29406-9171
Phone (843) 797-5050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180328001612 NC Practitioner - Physician Assistant 7517229792 Reassigns benefits to 1 organization
I20220916001843 SC Practitioner - Physician Assistant 7517229792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arcis Healthcare LLCGroup PAC ID 0042448748, 34 clinicians

Practice addresses (Care Compare)

130 E 3Rd N St
Summerville, SC 29483-6810
Phone (843) 797-5050

2880 Tricom St
North Charleston, SC 29406-9171
Phone (843) 797-5050

9565 Hwy 78
BLDG 100
Ladson, SC 29456-4118
Phone (843) 797-5050

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-07819NCMDOrthopaedic Surgery Physician
4534SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Arcis Healthcare, LLC CurrentSince Sep 1, 2022 Accepting new patients
Cape Fear Orthopaedic Clinic, P.a. Orthopaedic Surgery CurrentSince Jan 22, 2018 Accepting new patients
Arcis Healthcare, LLC Orthopaedic Surgery CurrentSince Sep 1, 2022 Accepting new patients

Locations

4140 Ferncreek Dr
Ste 801
Fayetteville, NC 28314
Phone (910) 484-2171

2880 Tricom St
North Charleston, SC 29406
Phone (843) 797-5050

Interoperability endpoints

  • Direct secure messaging: carey.lennon.1@7388.direct.athenahealth.com
  • Direct secure messaging: carey.lennon.p1@direct.capefearortho.nextgenshare.com

Organizations & group practices 4

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 2

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": "1515628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1336657428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 TRICOM ST",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069171",
            "telephone_number": "843-797-5050",
            "fax_number": "843-797-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 TRICOM ST",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069171",
            "telephone_number": "843-797-5050",
            "fax_number": "843-797-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENNON",
        "first_name": "CAREY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-11",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SC",
            "license": "4534",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "0010-07819",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

Verify at the official NPI Registry.