NPIMap

Individual provider Active NPI

Lady M. Carr, MD

  • Internal Medicine Physician
  • Columbia, SC
National Provider Identifier
1629029913
Registry record updated Aug 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
21596 Issued in SC
Practice address
610 Faison Dr
Columbia, SC 29203-3218
Phone
(803) 898-8405
Fax
(803) 898-8526
NPI assigned
May 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 21596 SC Primary

Addresses

Primary practice location

610 Faison Dr
Columbia, SC 29203-3218

Mailing address

PO Box 485
Columbia, SC 29202-0485
Phone (803) 898-8405

Other identifiers 1

IdentifierTypeStateIssuer
215966MedicaidSC

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
I20040506001165 SC Practitioner - Internal Medicine 1254320203 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Florida College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Carolina Dept of Mental Health Accounting Office 226 clinicians

Practice addresses (Care Compare)

610 Faison Dr
Columbia, SC 29203-3218
Phone (803) 898-8523

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21596SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Oct 21, 2006 Accepting new patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Jul 1, 2014 Accepting new patients
South Carolina Dept of Mental Health Accounting Office Current Accepting new patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Oct 21, 2006 Accepting new patients
South Carolina Dept of Mental Health Accounting Office Current Accepting new patients

Locations

2414 Bull St
#3183
Columbia, SC 29201

2200 Harden St
Columbia, SC 29203
Phone (803) 737-5300

2414 Bull St
Columbia, SC 29201
Phone (803) 898-2461

2100 Bull St
Columbia, SC 29201
Phone (803) 898-1574

610 Faison Dr
Columbia, SC 29203
Phone (803) 898-8523

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282608000000",
    "number": "1629029913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 485",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292020485",
            "telephone_number": "803-898-8405",
            "fax_number": "803-898-8526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 FAISON DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292033218",
            "telephone_number": "803-898-8405",
            "fax_number": "803-898-8526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "LADY",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2010-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "21596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "215966",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.