Individual provider Active NPI

Lauren Podoll, PA

  • Physician Assistant
  • Summerville, SC
National Provider Identifier
1336851278
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4611 Issued in SC
Practice address
1101 Old Trolley Rd Ste 300
Summerville, SC 29485-5294
Phone
(843) 695-6071
Fax
(843) 569-5879
NPI assigned
Dec 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4611 SC Primary

Addresses

Primary practice location

1101 Old Trolley Rd Ste 300
Summerville, SC 29485-5294

Mailing address

PO Box 530062
Atlanta, GA 30353-0062
Phone (843) 695-6071

Other identifiers 1

IdentifierTypeStateIssuer
1336851278MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230118000053 SC Practitioner - Physician Assistant 0840661500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
PPCP Specialty Physicians , LLCGroup PAC ID 2466723028, 20 clinicians

Practice addresses (Care Compare)

7 S Alliance Dr
Suite 202a
Goose Creek, SC 29445-7269
Phone (843) 376-0670

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
PPCP Specialty Physicians , LLC CurrentSince Jan 9, 2023 Accepting new patients
PPCP Specialty Physicians , LLC CurrentSince Jan 9, 2023 Accepting new patients
PPCP Specialty Physicians , LLC Past Accepting new patients
PPCP Specialty Physicians , LLC Past Accepting new patients

Locations

7 S Alliance Dr
Ste 202A
Goose Creek, SC 29445
Phone (843) 376-6070

1101 Old Trolley Rd
Ste 300
Summerville, SC 29485
Phone (843) 376-2670

Interoperability endpoints

  • Direct secure messaging: lauren.podoll@ppcp1.eclinicaldirectplus.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 and National Provider Directory roles.

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": "1671667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1336851278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530062",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303530062",
            "telephone_number": "843-695-6071",
            "fax_number": "843-569-5879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 OLD TROLLEY RD STE 300",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294855294",
            "telephone_number": "843-695-6071",
            "fax_number": "843-569-5879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODOLL",
        "first_name": "LAUREN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-22",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336851278",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.