NPIMap

Organization Active NPI

Lexington County Health Services District, Inc.

Doing business as Lakeside Pediatrics

  • Pediatrics Physician
  • West Columbia, SC
National Provider Identifier
1578855805
Registry record updated Sep 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
9453 Issued in SC
Legal business name
LEXINGTON COUNTY HEALTH SERVICES DISTRICT, INC.
Doing business as
Lakeside Pediatrics
Practice address
3240 Sunset Blvd
West Columbia, SC 29169
Phone
(803) 808-0523
Fax
(803) 794-6503
NPI assigned
May 4, 2011
Organization subpart
Yes
Parent organization
LEXINGTON COUNTY HEALTH SERVICES DISTRICT, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 18, 2018

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

Authorized official

Name
Melinda Sarvis
Title
Executive VP
Phone
(803) 791-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 9453 SC Primary

Addresses

Primary practice location

3240 Sunset Blvd
West Columbia, SC 29169

Mailing address

PO Box 896239
Charlotte, NC 28289-6239
Phone (803) 808-0523

Other names 1

  • Lakeside Pediatrics Doing business as

National Provider Directory

National Provider Directory
Part of
Lexington County Health

NPI Registry JSON

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537228800000",
    "number": "1578855805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 896239",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282896239",
            "telephone_number": "803-808-0523",
            "fax_number": "803-794-6503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 SUNSET BLVD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "29169",
            "telephone_number": "803-808-0523",
            "fax_number": "803-794-6503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEXINGTON COUNTY HEALTH SERVICES DISTRICT, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LEXINGTON COUNTY HEALTH SERVICES DISTRICT, INC.",
        "enumeration_date": "2011-05-04",
        "last_updated": "2018-09-18",
        "status": "A",
        "authorized_official_last_name": "SARVIS",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_title_or_position": "EXECUTIVE VP",
        "authorized_official_telephone_number": "803-791-2000"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "9453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lakeside Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.