Individual provider Active NPI

Lorena Middleton, FNP

  • Family Nurse Practitioner
  • West Columbia, SC
National Provider Identifier
1891164216
Registry record updated Aug 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19734 Issued in SC
Practice address
103 Saluda Ridge CT
West Columbia, SC 29169-3455
Phone
(803) 794-3320
Fax
(803) 794-3157
NPI assigned
Sep 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 19734 SC Primary

Addresses

Primary practice location

103 Saluda Ridge CT
West Columbia, SC 29169-3455

Mailing address

PO Box 743904
Atlanta, GA 30374-3904
Phone (803) 794-3320

Other practice location 1

103 Saluda Ridge Ct
West Columbia, SC 29169
Phone (803) 794-3320

Other identifiers 1

IdentifierTypeStateIssuer
NP3448MedicaidSC

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151121000244 SC Practitioner - Nurse Practitioner 5698075703 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Internal Medicine & Primary Care, PA CurrentSince Sep 21, 2015 Accepting new patients

Locations

300 W Butler Rd
Mauldin, SC 29662
Phone (864) 277-8300

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": "1442275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1891164216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-794-3320",
            "fax_number": "803-794-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 SALUDA RIDGE CT",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693455",
            "telephone_number": "803-794-3320",
            "fax_number": "803-794-3157"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 Saluda Ridge Ct",
            "address_purpose": "LOCATION",
            "city": "West Columbia",
            "state": "SC",
            "postal_code": "29169",
            "country_code": "US",
            "telephone_number": "803-794-3320",
            "fax_number": "803-794-3157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIDDLETON",
        "first_name": "LORENA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-15",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "19734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP3448",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

Verify at the official NPI Registry.