Medexpress Primary Care South Carolina, P.C.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

MEDEXPRESS PRIMARY CARE SOUTH CAROLINA, P.C.

Practice address

2480 Two Notch Rd
Lexington, SC 29072

Phone

(803) 951-5871

Fax

(803) 951-5872

NPI assigned

Jun 20, 2018

Organization subpart

No

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

Authorized official

Name

Brett Gall

Title

Director Payor Contracting

Phone

(304) 225-2500

Specialties & licenses 2

Addresses

Other names 1

• Lexington Michelin Family Health Center Doing business as

Locations

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530489600000",
    "number": "1548754724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 CONSOL ENERGY DR",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153176506",
            "telephone_number": "304-225-2500",
            "fax_number": "724-743-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 TWO NOTCH RD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "29072",
            "telephone_number": "803-951-5871",
            "fax_number": "803-951-5872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDEXPRESS PRIMARY CARE SOUTH CAROLINA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-20",
        "last_updated": "2018-07-02",
        "status": "A",
        "authorized_official_last_name": "GALL",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "DIRECTOR PAYOR CONTRACTING",
        "authorized_official_telephone_number": "304-225-2500"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lexington Michelin Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelley Jordan McSwain
• Meaningful Milestones LLC
• Jacy Meanor
• Med Mart Lex
• Med Mart Lex LLC
• Medfirst Diabetic Shoes & Supplies
• Medical Comfort Systems, Inc.
• Medical Services of America Inc
• Mark Andrew Medlin, D.M.D.
• Amber Medlock, OTR/L

• General Practice Physician in Lexington, SC
• Providers in Lexington, SC by specialty
• General Practice Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.