NPIMap

Organization Active NPI

Lexington County Health Serv

Doing business as Lexington Family Practice Lake Murray

  • Family Medicine Physician
  • Lexington, SC
National Provider Identifier
1629096581
Registry record updated Nov 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LEXINGTON COUNTY HEALTH SERV
Doing business as
Lexington Family Practice Lake Murray
Practice address
2006 Augusta Hwy
Lexington, SC 29072-4810
Phone
(803) 785-4747
Fax
(803) 785-4750
NPI assigned
Jul 18, 2006
Last updated
Nov 23, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
LEXINGTON COUNTY HEALTH SERVICES DISTRICT INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 23, 2016

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

Authorized official

Name
Melinda P. Kruzner
Title
Executive Vice President
Phone
(803) 791-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

2006 Augusta Hwy
Lexington, SC 29072-4810

Mailing address

508 Hulon LN
West Columbia, SC 29169-3439
Phone (803) 785-4747

Other identifiers 1

IdentifierTypeStateIssuer
GP3226MedicaidSC

Other names 1

  • Lexington Family Practice Lake Murray Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D0990564Lexington Family Practice-Lake Murray2006 Augusta Hwy, Lexington, SC 29072AccreditationAug 18, 2026

National Provider Directory

National Provider Directory
Part of
Lexington Family Practi

Locations

508 Hulon Ln
West Columbia, SC 29169
Phone (803) 791-2460

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479859200000",
    "number": "1629096581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 HULON LN",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693439",
            "telephone_number": "803-785-4747",
            "fax_number": "803-785-4750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 AUGUSTA HWY",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290724810",
            "telephone_number": "803-785-4747",
            "fax_number": "803-785-4750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEXINGTON COUNTY HEALTH SERV",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LEXINGTON COUNTY HEALTH SERVICES DISTRICT INC.",
        "enumeration_date": "2006-07-18",
        "last_updated": "2016-11-23",
        "status": "A",
        "authorized_official_last_name": "KRUZNER",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "803-791-2000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3226",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lexington Family Practice Lake Murray",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lexington, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.