Individual provider Active NPI

Justin Tyler Fox, DO

  • Student in an Organized Health Care Education/Training Program
  • West Columbia, SC
National Provider Identifier
1750073573
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
145 Sunset CT Ste 100
West Columbia, SC 29169-2429
Phone
(803) 739-3491
NPI assigned
May 22, 2023
Last updated
Mar 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

145 Sunset CT Ste 100
West Columbia, SC 29169-2429

Mailing address

145 Sunset CT Ste 100
West Columbia, SC 29169-2429
Phone (803) 739-3491

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jfox164837@direct.lexmed.com

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
I20230802003491 SC Order and Referring Only - Family PracticePractitioner - Family Practice 6709247075

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington County Health Services District Inc Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jfox164837@direct.lexmed.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1750073573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 SUNSET CT STE 100",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291692429",
            "telephone_number": "803-739-3491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 SUNSET CT STE 100",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291692429",
            "telephone_number": "803-739-3491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "JUSTIN",
        "middle_name": "TYLER",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-22",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jfox164837@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "145 Sunset Ct Ste 100",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291692429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

Verify at the official NPI Registry.