Individual provider Active NPI

Raymond A. Reiser, M.D.

  • Pediatrics Physician
  • Rock Hill, SC
National Provider Identifier
1700107240
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
36624 Issued in SC
Practice address
455 Lakeshore Pkwy
Rock Hill, SC 29730-4205
Phone
(803) 909-6363
Fax
(877) 658-8669
NPI assigned
Jun 18, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 36624 SC Primary

Addresses

Primary practice location

455 Lakeshore Pkwy
Rock Hill, SC 29730-4205

Mailing address

455 Lakeshore Pkwy
Rock Hill, SC 29730-4205
Phone (803) 909-6363

Other identifiers 1

IdentifierTypeStateIssuer
366240MedicaidSC

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140908001780 SC Practitioner - Pediatric Medicine 7618196528 Reassigns benefits to 8 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36624SCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Little River Medical Center Inc CurrentSince Jul 6, 2014 Accepting new patients
Little River Medical Center, Inc CurrentSince Feb 12, 2017 Accepting new patients
Affinity Health Center CurrentSince Dec 1, 2025 Accepting new patients
Affinity Health Center CurrentSince Dec 1, 2025 Accepting new patients
McLeod Loris Seacoast Hospital CurrentSince Feb 1, 2019 Accepting new patients
Little River Medical Center, Inc. Pediatrics CurrentSince Feb 27, 2017 Accepting new patients
McLeod Loris Seacoast Hospital CurrentSince Feb 1, 2019 Accepting new patients
Little River Medical Center, Inc. CurrentSince Mar 6, 2017 Accepting new patients
Little River Medical Center, Inc. CurrentSince Jan 1, 2017 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

4303 Live Oak Dr
Little River, SC 29566
Phone (803) 839-3939

3817 Main St
Loris, SC 29569
Phone (843) 663-8297

3655 Mitchell St
Loris, SC 29569
Phone (843) 716-7000

4220 Carolina Exchange Dr
Myrtle Beach, SC 29579
Phone (843) 663-8013

3515 Caduceus Dr
Ste B
Myrtle Beach, SC 29588
Phone (843) 651-5689

7724 N Kings Hwy
Myrtle Beach, SC 29572
Phone (843) 839-3939

455 Lakeshore Pkwy
Rock Hill, SC 29730
Phone (803) 909-6363

Interoperability endpoints

  • Direct secure messaging: raymond.reiser@lrmcenter.eclinicaldirectplus.com

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1700107240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 LAKESHORE PKWY",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297304205",
            "telephone_number": "803-909-6363",
            "fax_number": "803-909-6390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 LAKESHORE PKWY",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297304205",
            "telephone_number": "803-909-6363",
            "fax_number": "877-658-8669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISER",
        "first_name": "RAYMOND",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-18",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "36624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "366240",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.