NPIMap

Individual provider Active NPI

Manuel Fachado Jr., D.O.

  • Family Medicine Physician
  • Lancaster, SC
National Provider Identifier
1740228394
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
940 Issued in SC
Practice address
800 W Meeting St
Lancaster, SC 29720-2202
Phone
(803) 286-1479
Fax
(803) 286-1369
NPI assigned
Jun 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 940 SC
Family Medicine Physician 207Q00000X 940 SC Primary

Addresses

Primary practice location

800 W Meeting St
Lancaster, SC 29720-2202

Mailing address

12315 Greenville Hwy
Lyman, SC 29365-1515
Phone (864) 439-4376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060206000794 SC Practitioner - Family Practice 2062426448 Reassigns benefits to 2 organizations
I20100308000240 TX Practitioner - Emergency MedicinePractitioner - Family Practice 2062426448 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
940SCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newberry County Memorial Hospital Family Medicine CurrentSince Nov 15, 2024 Accepting new patients
Pueblo Pintado Clinic Current Accepting new patients
DHHS IHS Phoenix Area CurrentSince Oct 26, 2015 Accepting new patients
Thoreau Clinic CurrentSince Jan 22, 2018 Accepting new patients
Newberry County Memorial Hospital Emergency Medicine CurrentSince Nov 15, 2024 Accepting new patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Jan 28, 2020 Accepting new patients
South Carolina Dept of Mental Health Accounting Office Current Accepting new patients
DHHS PHS Naihs Crownpoint Hospital Current Accepting new patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Jan 28, 2020 Accepting new patients
DHHS IHS Phoenix Area CurrentSince Oct 26, 2015 Accepting new patients
South Carolina Em-I Medical Services, PC Emergency Medicine Past Accepting new patients
Boyce Emergency Group PC Emergency Medicine Past Accepting new patients
Fig Tree Medical Past Accepting new patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine Past Accepting new patients
Quentin N Burdick Comprehensive Health Care Facility PastSince Jul 21, 2015 Accepting new patients
Wren Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

220 Faison Dr
Columbia, SC 29203
Phone (803) 898-1662

2414 Bull St
Columbia, SC 29201
Phone (803) 898-2461

2669 Kinard St
Newberry, SC 29108
Phone (803) 276-7570

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213315200000",
    "number": "1740228394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12315 GREENVILLE HWY",
            "city": "LYMAN",
            "state": "SC",
            "postal_code": "293651515",
            "telephone_number": "864-439-4376",
            "fax_number": "864-439-4385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W MEETING ST",
            "city": "LANCASTER",
            "state": "SC",
            "postal_code": "297202202",
            "telephone_number": "803-286-1479",
            "fax_number": "803-286-1369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FACHADO",
        "first_name": "MANUEL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2008-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "940",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, SC

Sources for this page

Verify at the official NPI Registry.