Organization Active NPI

Trinity Family Practice

  • Family Medicine Physician
  • Anderson, SC
National Provider Identifier
1700349784
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TRINITY FAMILY PRACTICE
Practice address
4144 Clemson Blvd
Anderson, SC 29621-1108
Phone
(864) 224-3332
NPI assigned
Apr 8, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Authorized official

Name
Christine LawrenceNPI 1053750257
Title
Ceo
Phone
(864) 224-9598

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

4144 Clemson Blvd
Anderson, SC 29621-1108

Mailing address

4144 Clemson Blvd
Anderson, SC 29621-1108
Phone (864) 224-9598

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190625002807 SC Part B Supplier - Clinic/Group Practice 3577897578 Receives reassigned benefits from 2 practitioners
Practice locations: Anderson, SC

National Provider Directory

National Provider Directory

Locations

4144 Clemson Blvd
Anderson, SC 29621
Phone (864) 224-3332

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639699200000",
    "number": "1700349784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4144 CLEMSON BLVD",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296211108",
            "telephone_number": "864-224-9598",
            "fax_number": "864-226-2462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4144 CLEMSON BLVD",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296211108",
            "telephone_number": "864-224-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-08",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "864-224-9598"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.