Lexington County Health Services District, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LEXINGTON COUNTY HEALTH SERVICES DISTRICT, INC.

Doing business as

Lexington Family Practice Irmo

Practice address

7037 St Andrews Road
Columbia, SC 29212

Phone

(803) 732-0963

Fax

(803) 732-1406

NPI assigned

Jul 8, 2006

Organization subpart

Yes

Parent organization

LEXINGTON COUNTY HEALTH SERVICES DISTRICT, INC.As reported in NPPES

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

Authorized official

Name

Melinda P Kruzner

Title

Executive Vice President

Phone

(803) 791-2000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lexington Family Practice Irmo Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Lexington County Health

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546819200000",
    "number": "1770516569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 HULON LN",
            "address_2": "ATTN: VP REVENUE CYCLE",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694841",
            "telephone_number": "803-791-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7037 ST ANDREWS ROAD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29212",
            "telephone_number": "803-732-0963",
            "fax_number": "803-732-1406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEXINGTON COUNTY HEALTH SERVICES DISTRICT, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LEXINGTON COUNTY HEALTH SERVICES DISTRICT, INC.",
        "enumeration_date": "2006-07-08",
        "last_updated": "2019-01-07",
        "status": "A",
        "authorized_official_last_name": "KRUZNER",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "803-791-2000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2392",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lexington Family Practice Irmo",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lexington Family Practice Irmo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lexington County Health Services District, Inc.
• Lexington County Health Services District, Inc.
• Lexington County Health Services District, Inc.
• Lexington County Health Services District, Inc.
• Lexington County Health Services District, Inc.
• Lexington County Health Services District, Inc.
• Lexington County Health Services District, Inc.
• Lexington County Health Services District, Inc.
• Lexington County Health Services District, Inc.
• Lexington County Health Services Districts, Inc.

• Family Medicine Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.