NPIMap

Organization Active NPI

Lovelace Family Medicine, PA

  • Primary Care Clinic/Center
  • Prosperity, SC
National Provider Identifier
1366429987
Registry record updated Oct 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
LOVELACE FAMILY MEDICINE, PA
Practice address
600 N Wheeler Ave
Prosperity, SC 29127
Phone
(803) 364-4852
Fax
(803) 364-2014
NPI assigned
Dec 23, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2007

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

Authorized official

Name
Linda M Kinard
Title
Practice Manager
Phone
(803) 364-1011

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X SC Primary
Clinical Medical Laboratory 291U00000X SC
Clinical Medical Laboratory 291U00000X SC

Addresses

Primary practice location

600 N Wheeler Ave
Prosperity, SC 29127

Mailing address

PO Box 630
Prosperity, SC 29127-0630
Phone (803) 364-4852

Other identifiers 4

IdentifierTypeStateIssuer
GP3757MedicaidSC
0739330001OtherSCDME/MEDICARE
DM0459OtherSCDME/MEDICAID
GP0018MedicaidSC

Other names 1

  • Lovelace Family Medical Center Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040130000193 SC Part B Supplier - Clinic/Group Practice 6002719655 Receives reassigned benefits from 9 practitioners
Practice locations: Newberry, SC; Prosperity, SC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D0248922Lovelace Family Medicine Center600 N Wheeler Ave, Prosperity, SC 29127AccreditationDec 22, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191283200000",
    "number": "1366429987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 630",
            "city": "PROSPERITY",
            "state": "SC",
            "postal_code": "291270630",
            "telephone_number": "803-364-4852",
            "fax_number": "803-364-2014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N WHEELER AVE",
            "city": "PROSPERITY",
            "state": "SC",
            "postal_code": "29127",
            "telephone_number": "803-364-4852",
            "fax_number": "803-364-2014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOVELACE FAMILY MEDICINE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-23",
        "last_updated": "2007-10-02",
        "status": "A",
        "authorized_official_last_name": "KINARD",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "803-364-1011"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "SC",
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "SC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3757",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME/MEDICARE",
            "identifier": "0739330001",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME/MEDICAID",
            "identifier": "DM0459",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0018",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lovelace Family Medical Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Prosperity, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.