NPIMap

Individual provider Active NPI

Jordan Ronnie Lawson, PA-C

  • Nephrology Physician
  • Spartanburg, SC
National Provider Identifier
1609557800
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
5300PA Issued in SC
Practice address
126 Dillon Dr.
Spartanburg, SC 29307-1018
Phone
(864) 327-1212
Fax
(864) 327-1211
NPI assigned
Jul 31, 2023
Last updated
Mar 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5099 SC
Nephrology Physician 207RN0300X 5300PA SC Primary

Addresses

Primary practice location

126 Dillon Dr.
Spartanburg, SC 29307-1018

Mailing address

126 Dillon Dr.
Spartanburg, SC 29307-1018
Phone (864) 327-1212

Other identifiers 1

IdentifierTypeStateIssuer
6502PAMedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231107003993 SC Practitioner - Physician Assistant 3173970530 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foothills Nephrology PCGroup PAC ID 0244122521, 7 clinicians

Practice addresses (Care Compare)

126 Dillon Dr
Spartanburg, SC 29307-1018
Phone (864) 327-1212

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5300PASCMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Self Regional Healthcare Partners CurrentSince Jul 1, 2024 Accepting new patients
Self Medical Group CurrentSince Dec 4, 2023 Accepting new patients
Self Medical Group CurrentSince Dec 4, 2023 Accepting new patients
Self Regional Healthcare Partners CurrentSince Jul 1, 2024 Accepting new patients

Locations

75 Remittance Dr
Dept 6764
Chicago, IL 60675

300 Ridge Medical Plaza Rd
Edgefield, SC 29824
Phone (803) 637-3174

421 Epting Ave
Greenwood, SC 29646
Phone (864) 227-6818

2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1609557800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 DILLON DR.",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071018",
            "telephone_number": "864-327-1212",
            "fax_number": "864-327-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 DILLON DR.",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071018",
            "telephone_number": "864-327-1212",
            "fax_number": "864-327-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWSON",
        "first_name": "JORDAN",
        "middle_name": "RONNIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-31",
        "last_updated": "2025-03-05",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "5099",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "SC",
            "license": "5300PA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6502PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.