Individual provider Active NPI

Eugene M Lepine, MD

  • Dermatology Physician
  • Rock Hill, SC
National Provider Identifier
1508864927
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
06954 Issued in SC
Practice address
1533 Ebenezer Rd
Rock Hill, SC 29732-1806
Phone
(803) 328-1831
Fax
(803) 328-0283
NPI assigned
Jul 10, 2005
Reactivated
Oct 17, 2007
Last updated
Nov 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 06954 SC
Dermatology Physician 207N00000X 06954 SC Primary

Addresses

Primary practice location

1533 Ebenezer Rd
Rock Hill, SC 29732-1806

Mailing address

1533 Ebenezer Rd
Rock Hill, SC 29732-1806
Phone (803) 328-1831

Other identifiers 1

IdentifierTypeStateIssuer
069543MedicaidSC

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
I20100127000262 SC Practitioner - Dermatology 7416099627 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
06954SCMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Rock Hill Dermatology Center Specialist CurrentSince Jan 11, 1996 Accepting new patients

Locations

1533 Ebenezer Rd
Rock Hill, SC 29732
Phone (803) 328-1831

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1120953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1508864927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1533 EBENEZER RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321806",
            "telephone_number": "803-328-1831",
            "fax_number": "803-324-5131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1533 EBENEZER RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321806",
            "telephone_number": "803-328-1831",
            "fax_number": "803-328-0283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEPINE",
        "first_name": "EUGENE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-10",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "deactivation_date": "2006-03-22",
        "reactivation_date": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "SC",
            "license": "06954",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "SC",
            "license": "06954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "069543",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.