NPIMap

Individual provider Active NPI

Lisa M Wright, M.D.

  • Family Medicine Physician
  • Lake City, SC
National Provider Identifier
1700825858
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25363 Issued in SC
Practice address
276 N Ron McNair Blvd
Lake City, SC 29560-2462
Phone
(843) 394-5471
Fax
(433) 945-4598
NPI assigned
Jun 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25363 SC Primary

Addresses

Primary practice location

276 N Ron McNair Blvd
Lake City, SC 29560-2462

Mailing address

276 N Ron McNair Blvd
Lake City, SC 29560-2462
Phone (843) 394-5471

Other identifiers 4

IdentifierTypeStateIssuer
253638MedicaidSC
576007863002OtherSCBLUE CHOICE OF SC
576007863002OtherSCBCBS OF SC
P00352728OtherSCRR MEDICARE

Other names 1

  • Lisa Marie Mattox Former name

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
I20040810001008 SC Practitioner - Family Practice 3779555750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Meharry Medical College School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical University Hospital AuthorityGroup PAC ID 1557268950, 218 clinicians

Practice addresses (Care Compare)

276 N Ron McNair Blvd
Lake City, SC 29560-2462
Phone (843) 394-5471

Hospital & facility affiliations

  • Amedisys Home Health Care Home health agency, Kingstree, SC, CCN 427068
  • Centerwell Home Health Home health agency, Myrtle Beach, SC, CCN 427045
  • Musc Health at Home by Bayada-Conway Home health agency, Conway, SC, CCN 427135
  • Centerwell Home Health-Pee Dee Home health agency, Florence, SC, CCN 427854
  • Musc Health Florence Medical Center Hospital, Florence, SC, CCN 420091
  • CCN 420117 Hospital, CCN 420117
  • Musc Medical Center Hospital, Charleston, SC, CCN 420004
  • McLeod Regional Medical Center-Pee Dee Hospital, Florence, SC, CCN 420051
  • Tidelands Georgetown Memorial Hospital Hospital, Georgetown, SC, CCN 420020

Merit-based Incentive Payment System (MIPS)

Final score
90.15 of 100Reported as group
Quality
83.18
Promoting interoperability
98
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25363SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical University Hospital Authority CurrentSince Jul 10, 2023 Accepting new patients
Medical University Hospital Authority CurrentSince Jul 10, 2023 Accepting new patients
Medical University Hospital Authority Current Accepting new patients
Greenville Health System Past Accepting new patients
Medical University Hospital Authority Family Medicine Past Accepting new patients
Medical University Hospital Authority Past Accepting new patients

Locations

500 Thurgood Marshall Hwy
Ste F
Kingstree, SC 29556
Phone (843) 355-1774

276 N Ron McNair Blvd
Lake City, SC 29560
Phone (843) 394-1051

148 Sauls St
Ste C
Lake City, SC 29560
Phone (843) 374-3621

511 S Main St
Mullins, SC 29574
Phone (843) 464-8244

Interoperability endpoints

  • Direct secure messaging: lwright432673@direct.musc.edu
  • Direct secure messaging: lisa.wright@hca5.eclinicaldirectplus.com

Organizations & group practices 6

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.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1700825858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 N RON MCNAIR BLVD",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295602462",
            "telephone_number": "843-394-5471",
            "fax_number": "433-945-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 N RON MCNAIR BLVD",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295602462",
            "telephone_number": "843-394-5471",
            "fax_number": "433-945-4598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "25363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253638",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE OF SC",
            "identifier": "576007863002",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF SC",
            "identifier": "576007863002",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00352728",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "MATTOX",
            "middle_name": "MARIE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lake City, SC

Sources for this page

Verify at the official NPI Registry.