Individual provider Active NPI

Elaine B Baxley, MD

  • Occupational Medicine Physician
  • Lugoff, SC
National Provider Identifier
1831150226
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
12579 Issued in SC
Practice address
643 Highway 1 S
Lugoff, SC 29078-9174
Phone
(803) 243-0988
NPI assigned
Mar 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 12579 SC
Family Medicine Physician 207Q00000X 12579 SC
Occupational Medicine Physician 2083X0100X 12579 SC Primary

Addresses

Primary practice location

643 Highway 1 S
Lugoff, SC 29078-9174

Mailing address

1606 Lakeview Ave
Camden, SC 29020-2929
Phone (803) 243-0988

Other practice location 1

2513 Broad St
Camden, SC 29020-2237
Phone (803) 243-0988

Other identifiers 1

IdentifierTypeStateIssuer
125796MedicaidSC

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
I20110419000263 SC Practitioner - Emergency Medicine 0143405035

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12579SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Care SC, PA Emergency Medicine Past Accepting new patients
Doctors Care, PA Emergency Medicine Past Accepting new patients

Organizations & group practices 2

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1831150226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606 LAKEVIEW AVE",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290202929",
            "telephone_number": "803-243-0988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "643 HIGHWAY 1 S",
            "city": "LUGOFF",
            "state": "SC",
            "postal_code": "290789174",
            "telephone_number": "803-243-0988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2513 Broad St",
            "address_purpose": "LOCATION",
            "city": "Camden",
            "state": "SC",
            "postal_code": "290202237",
            "country_code": "US",
            "telephone_number": "803-243-0988",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAXLEY",
        "first_name": "ELAINE",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "12579",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "12579",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "SC",
            "license": "12579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125796",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lugoff, SC

Sources for this page

Verify at the official NPI Registry.