Lakeside Medical Response

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

234 Issued in SC

Legal business name

LAKESIDE MEDICAL RESPONSE

Practice address

1801D W Evans St Ste 110
Florence, SC 29501-3333

Phone

(843) 629-7133

Fax

(843) 629-7233

NPI assigned

Oct 10, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Shameeka McDuffie

Title

Owner

Phone

(843) 629-7133

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618876800000",
    "number": "1811085657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801D W EVANS ST STE 110",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295013333",
            "telephone_number": "843-629-7133",
            "fax_number": "843-629-7233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801D W EVANS ST STE 110",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295013333",
            "telephone_number": "843-629-7133",
            "fax_number": "843-629-7233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE MEDICAL RESPONSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A",
        "authorized_official_last_name": "MCDUFFIE",
        "authorized_official_first_name": "SHAMEEKA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-629-7133",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "SC",
            "license": "234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laboratory Corporation of America Holdings
• Laboratory Corporation of America Holdings
• Laboratory Corporation of America Holdings
• Patricia Lage, MD
• Martha Lair, PT
• Lakeside Medical Response Tri County, LLC
• Todd Alan Laliberte, OTR/L
• James D. Lamm, M.D.
• Marie Lamparter
• Tamra Davis Lampley, RN

• Land Ambulance in Florence, SC
• Providers in Florence, SC by specialty
• Land Ambulance in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.