Individual provider Active NPI

Marshall Scott Wingo, M.D.

  • Urology Physician
  • North Charleston, SC
National Provider Identifier
1831395334
Registry record updated Jul 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
24132 Issued in SC
Practice address
2687 Lake Park Dr
North Charleston, SC 29406-9100
Phone
(843) 572-1010
Fax
(843) 569-1719
NPI assigned
Jun 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 24132 SC Primary

Addresses

Primary practice location

2687 Lake Park Dr
North Charleston, SC 29406-9100

Mailing address

2687 Lake Park Dr
North Charleston, SC 29406-9100
Phone (843) 572-1010

Other identifiers 1

IdentifierTypeStateIssuer
241321MedicaidSC

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
I20070823000098 SC Practitioner - Urology 5698867562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Emory University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lowcountry Urology Clinics, PAGroup PAC ID 6406869247, 14 clinicians

Practice addresses (Care Compare)

2687 Lake Park Dr
North Charleston, SC 29406-9100
Phone (843) 572-1010

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24132SCMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lowcountry Urology Clinics PA Urology CurrentSince Aug 1, 2007 Accepting new patients
Lowcountry Urology Clinics, PA Urology CurrentSince Aug 1, 2007 Accepting new patients

Locations

641 Saint Andrews Blvd
Charleston, SC 29407
Phone (843) 577-6015

2687 Lake Park Dr
North Charleston, SC 29406
Phone (843) 572-0097

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343692800000",
    "number": "1831395334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2687 LAKE PARK DR",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069100",
            "telephone_number": "843-572-1010",
            "fax_number": "843-725-3118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2687 LAKE PARK DR",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069100",
            "telephone_number": "843-572-1010",
            "fax_number": "843-569-1719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINGO",
        "first_name": "MARSHALL",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-22",
        "last_updated": "2012-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "SC",
            "license": "24132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "241321",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

Verify at the official NPI Registry.