Lauren Frederic Visserman, M.D.

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

LL41118 Issued in SC

Practice address

135 Rutledge Ave FL 8
Charleston, SC 29425-6773

Phone

(843) 876-0888

NPI assigned

Apr 13, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Ms. Lauren Michelle Frederic Former name

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1492041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1497289607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 RUTLEDGE AVE FL 8",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258903",
            "telephone_number": "843-876-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 RUTLEDGE AVE FL 8",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294256773",
            "telephone_number": "843-876-0888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 W Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "NC",
            "postal_code": "272926773",
            "country_code": "US",
            "telephone_number": "336-243-8615",
            "fax_number": "336-724-8624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VISSERMAN",
        "first_name": "LAUREN",
        "middle_name": "FREDERIC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-13",
        "last_updated": "2021-07-08",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2020-02548",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "SC",
            "license": "LL41118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "FREDERIC",
            "middle_name": "MICHELLE",
            "prefix": "MS.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Vision Care Resources LLC
• Visionary Eye Center
• Visions Light Home Care
• Visionworks, Inc
• Joshua Visserman, M.D.
• Vitality Health, LLC
• Danielle Vizzini, CRNA
• Margaret Anne Vogel, LPC-A
• Rhonda L Vogel, CRNA
• Marsha Susan Voges, FNP

• Geriatric Medicine (Family Medicine) Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Geriatric Medicine (Family Medicine) Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.