NPIMap

Individual provider Active NPI

David Liebman, MD

  • Internal Medicine Physician
  • Clemson, SC
National Provider Identifier
1649234261
Registry record updated Jan 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
19038 Issued in SC
Practice address
885 Tiger Blvd
Clemson, SC 29631-1480
Phone
(864) 654-6800
Fax
(864) 654-7672
NPI assigned
Apr 12, 2006
Last updated
Jan 29, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2015

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 19038 SC Primary

Addresses

Primary practice location

885 Tiger Blvd
Clemson, SC 29631-1480

Mailing address

885 Tiger Blvd
Clemson, SC 29631-1480
Phone (864) 654-6800

Other identifiers 4

IdentifierTypeStateIssuer
110142647OtherRAILROAD MEDICARE
T30712MedicaidSC
0403518OtherCAROLINA CARE PLAN
72748OtherMEDCOST

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
I20100708000534 SC Practitioner - Family Practice 9032240098 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Emory University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

106 Waldrop St
Seneca, SC 29672-2354
Phone (864) 613-7323

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19038SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anmed Health CurrentSince Jul 15, 2014 Accepting new patients
Anmed Health CurrentSince Jul 15, 2014 Accepting new patients
Mountain Laurel Internal Medicine Internal Medicine CurrentSince Jul 2, 2018 Accepting new patients

Locations

800 N Fant St
Ste A
Anderson, SC 29621
Phone (864) 225-5131

885 Tiger Blvd
Clemson, SC 29631
Phone (864) 512-4530

106 Waldrop St
Seneca, SC 29672
Phone (864) 613-7323

Organizations & group practices 3

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 45

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422489600000",
    "number": "1649234261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 TIGER BLVD",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296311480",
            "telephone_number": "864-654-6800",
            "fax_number": "864-654-7672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 TIGER BLVD",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296311480",
            "telephone_number": "864-654-6800",
            "fax_number": "864-654-7672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBMAN",
        "first_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2015-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "19038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110142647",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T30712",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAROLINA CARE PLAN",
            "identifier": "0403518",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "72748",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clemson, SC

Sources for this page

Verify at the official NPI Registry.