Individual provider Active NPI

Scott Stockholm, DO

  • Critical Care Medicine (Internal Medicine) Physician
  • West Columbia, SC
National Provider Identifier
1407346182
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
89950 Issued in SC
Practice address
2720 Sunset Blvd
West Columbia, SC 29169-4810
Phone
(803) 936-7372
Fax
(803) 936-4102
NPI assigned
May 17, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 89950 SC Primary

Addresses

Primary practice location

2720 Sunset Blvd
West Columbia, SC 29169-4810

Mailing address

PO Box 6069
West Columbia, SC 29171-6069
Phone (803) 936-7372

Other practice location 1

1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 615-4321

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sstockholm177239@direct.lexmed.com

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
I20240814000132 SC Practitioner - Critical Care (Intensivists) 5496004145 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Edward Via Col of Osteo Medicine-Carolinas Campus, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lexington Health IncGroup PAC ID 2567872070, 905 clinicians

Practice addresses (Care Compare)

2720 Sunset Blvd
West Columbia, SC 29169-4810
Phone (803) 791-2460

Hospital & facility affiliations

  • Medical Services of America Hospice-Columbia Hospice, Columbia, SC, CCN 421531
  • Lexington Medical Center Hospital, West Columbia, SC, CCN 420073

Merit-based Incentive Payment System (MIPS)

Final score
84.09 of 100Reported as group
Quality
68.87
Promoting interoperability
100
Improvement activities
40
Cost
78.11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
89950SCMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington Health Inc Current Accepting new patients
Lexington County Health Services District Inc Current Accepting new patients
Lexington Health Inc Critical Care Medicine CurrentSince Jul 1, 2024 Accepting new patients
Lexington Health Inc CurrentSince Jul 1, 2024 Accepting new patients
Lexington County Health Services District, Inc. Past Accepting new patients
Lexington Health Inc Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

811 W Main St
Ste 101
Lexington, SC 29072
Phone (803) 936-7230

2720 Sunset Blvd
West Columbia, SC 29169
Phone (803) 791-2480

Interoperability endpoints

  • Direct secure messaging: sstockholm177239@direct.lexmed.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.

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": "1526515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1407346182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6069",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291716069",
            "telephone_number": "803-936-7372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 SUNSET BLVD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694810",
            "telephone_number": "803-936-7372",
            "fax_number": "803-936-4102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1638 Owen Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043424",
            "country_code": "US",
            "telephone_number": "910-615-4321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOCKHOLM",
        "first_name": "SCOTT",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-17",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "SC",
            "license": "89950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sstockholm177239@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "2720 Sunset Blvd",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

Verify at the official NPI Registry.