Individual provider Active NPI

Alicia Limbaugh Tolbert, M.D.

  • Family Medicine Physician
  • Clemson, SC
National Provider Identifier
1760542948
Registry record updated Aug 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
24081 Issued in SC
Practice address
522 College Ave
Suite 1
Clemson, SC 29631-1443
Phone
(864) 654-7841
Fax
(864) 654-7641
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2012

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 24081 SC Primary

Addresses

Primary practice location

522 College Ave
Suite 1
Clemson, SC 29631-1443

Mailing address

522 College Ave
Suite 1
Clemson, SC 29631-1443
Phone (864) 654-7841

Other identifiers 4

IdentifierTypeStateIssuer
2212OtherSCPRACTICE MEDICARE #
PC3475OtherSCPRACTICE MEICAID #
240812MedicaidSC
24081OtherSCSTATE LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 1, 2019 through Jul 1, 2027

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tiger Diagnostics Laboratory LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344384000000",
    "number": "1760542948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 COLLEGE AVE",
            "address_2": "SUITE 1",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296311443",
            "telephone_number": "864-654-7841",
            "fax_number": "864-654-7641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 COLLEGE AVE",
            "address_2": "SUITE 1",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296311443",
            "telephone_number": "864-654-7841",
            "fax_number": "864-654-7641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLBERT",
        "first_name": "ALICIA",
        "middle_name": "LIMBAUGH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2012-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "24081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRACTICE MEDICARE #",
            "identifier": "2212",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRACTICE MEICAID #",
            "identifier": "PC3475",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "240812",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "24081",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clemson, SC

Sources for this page

Verify at the official NPI Registry.