Individual provider Active NPI

Laura Holland Luke, M.D.

  • Pediatrics Physician
  • Columbia, SC
National Provider Identifier
1396763546
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
24949 Issued in SC
Practice address
3710 Landmark Dr Ste 310
Columbia, SC 29204-4034
Phone
(803) 898-1470
Fax
(803) 898-1471
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 24949 SC Primary
Pediatric Emergency Medicine (Emergency Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207PP0204X ME96449 FL
Pediatrics Physician 208000000X ME96449 FL

Addresses

Primary practice location

3710 Landmark Dr Ste 310
Columbia, SC 29204-4034

Mailing address

PO Box 743904
Atlanta, GA 30374-3904
Phone (803) 296-7320

Other identifiers 2

IdentifierTypeStateIssuer
101465300MedicaidFL
249494MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20091019000304 SC Practitioner - Pediatric Medicine 2365589645 Reassigns benefits to 1 organization
I20190118000804 FL Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 2365589645 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center CurrentSince Jan 15, 2018 Accepting new patients
Spartanburg Medical Center Multi-Specialty Current Accepting new patients
Halifax Healthcare Systems Inc Multi-Specialty CurrentSince Jan 7, 2019 Accepting new patients
Spartanburg Medical Center Multi-Specialty CurrentSince Jan 15, 2018 Accepting new patients
Volusia Pediatrics, LLC Pediatrics Past Accepting new patients
Acute Care Pediatrics of Palm Coast, PA Multi-Specialty Past Accepting new patients
Greenville Health System Past Accepting new patients

Locations

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

1041 Dunlawton Ave
Pt Orange, FL 32127
Phone (386) 322-4700

101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915

Interoperability endpoints

  • Direct secure messaging: laura.luke@224964652367876.direct.elationemr.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1396763546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-296-7320",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3710 LANDMARK DR STE 310",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292044034",
            "telephone_number": "803-898-1470",
            "fax_number": "803-898-1471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKE",
        "first_name": "LAURA",
        "middle_name": "HOLLAND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "24949",
            "primary": true
        },
        {
            "code": "207PP0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "FL",
            "license": "ME96449",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME96449",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101465300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "249494",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.