Individual provider Active NPI

Lorenzo Keith Sampson, MD

  • Surgery Physician
  • Aiken, SC
National Provider Identifier
1346213220
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
26694 Issued in SC
Practice address
410 University Pkwy Ste 2310
Aiken, SC 29801-6835
Phone
(803) 648-1318
Fax
(803) 642-7803
NPI assigned
Feb 10, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X K8468 TX
Surgery Physician 208600000X 26694 SC Primary

Addresses

Primary practice location

410 University Pkwy Ste 2310
Aiken, SC 29801-6835

Mailing address

367 S. Gulph Rd
Att: Ipm Credentialing
King of Prussia, PA 19406-3121
Phone (803) 648-1318

Other identifiers 3

IdentifierTypeStateIssuer
145641002MedicaidTX
266946MedicaidSC
8H8817OtherTXBCBS

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170728000494 SC Practitioner - General Surgery 5294716551 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Medical University of South Carolina College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

410 University Pkwy
Suite 2310
Aiken, SC 29801-6835
Phone (803) 648-1318

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy30
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)16
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux69
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aiken Professional Association LLC CurrentSince Aug 7, 2017 Accepting new patients
Aiken Professional Association, LLC Surgery CurrentSince Aug 7, 2017 Accepting new patients

Locations

367 S Gulph Rd
Kng of Prussa, PA 19406
Phone (610) 382-4422

137 Miracle Dr
Aiken, SC 29801
Phone (803) 226-0589

410 University Pkwy
Ste 2310
Aiken, SC 29801
Phone (803) 642-1318

Interoperability endpoints

  • Direct secure messaging: lsampson540330@selfregional.direct-ci.net

Organizations & group practices 2

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 3

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1346213220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 S. GULPH RD",
            "address_2": "ATT: IPM CREDENTIALING",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063121",
            "telephone_number": "803-648-1318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 UNIVERSITY PKWY STE 2310",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298016835",
            "telephone_number": "803-648-1318",
            "fax_number": "803-642-7803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPSON",
        "first_name": "LORENZO",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "K8468",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "26694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145641002",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266946",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8H8817",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

Verify at the official NPI Registry.