Lisa Creswell Myrick, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

8943 Issued in GA

Practice address

7182 Woodrow St Ste 200
Irmo, SC 29063-2832

Phone

(803) 749-1111

Fax

(803) 749-0050

NPI assigned

Sep 18, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lisa Diane Creswell Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Carolina Internal Medicine Associates and Rehabilitation LLCGroup PAC ID 1759362072, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lisa-myrick-1@scinternal.e-mdsdirect.com
• Direct secure messaging: lmyrick461676@direct.ghs.myhfn.org

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.

• South Carolina Internal Medicine Associates and Rehabilitation,L.L.C.

  • Internal Medicine Physician
  • Irmo, SC
  • NPI 1760483382
  Medicare reassignment Care Compare group
• Carolina Bone & Joint PA

  • Orthopaedic Surgery Physician
  • Irmo, SC
  • NPI 1699261917
  NPD (past)

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

{
    "created_epoch": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1669956538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7182 WOODROW ST STE 200",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632832",
            "telephone_number": "803-749-1111",
            "fax_number": "803-749-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7182 WOODROW ST STE 200",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632832",
            "telephone_number": "803-749-1111",
            "fax_number": "803-749-0050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Wellness Blvd Ste 114",
            "address_purpose": "LOCATION",
            "city": "Irmo",
            "state": "SC",
            "postal_code": "290632873",
            "country_code": "US",
            "telephone_number": "803-749-1111",
            "fax_number": "803-749-0050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7021 Saint Andrews Rd # 2",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292121177",
            "country_code": "US",
            "telephone_number": "803-749-1111",
            "fax_number": "803-749-0050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Wellness Blvd Ste 109",
            "address_purpose": "LOCATION",
            "city": "Irmo",
            "state": "SC",
            "postal_code": "290632872",
            "country_code": "US",
            "telephone_number": "803-749-1111",
            "fax_number": "803-749-0050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYRICK",
        "first_name": "LISA",
        "middle_name": "CRESWELL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-18",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "8943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC PA LICENSE",
            "identifier": "MPA3202PA",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lisa-myrick-1@scinternal.e-mdsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct message address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "lisa-myrick-1@scinternal.e-mdsdirect.com",
            "address_1": "7182 Woodrow St Ste 200",
            "city": "Irmo",
            "state": "SC",
            "country_code": "US",
            "postal_code": "290632832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "CRESWELL",
            "middle_name": "DIANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Medical Physician Assistant in Irmo, SC
• Providers in Irmo, SC by specialty
• Medical Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.