NPIMap

Individual provider Active NPI

Collin Lowell Tully, M.D.

  • Surgery Physician
  • West Columbia, SC
National Provider Identifier
1902232952
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
86679 Issued in SC
Practice address
146 E Hospital Dr Ste 400
West Columbia, SC 29169-4800
Phone
(803) 936-3300
Fax
(803) 936-7735
NPI assigned
Sep 23, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 57-022723 OH
Surgery Physician 208600000X 86679 SC Primary

Addresses

Primary practice location

146 E Hospital Dr Ste 400
West Columbia, SC 29169-4800

Mailing address

PO Box 6069
West Columbia, SC 29171-6069
Phone (803) 936-3300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ctully147641@direct.lexmed.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181010000152 FL Practitioner - General Surgery 3678878675 Reassigns benefits to 1 organization
I20210908002611 SC Practitioner - General Surgery 3678878675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Florida State University College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lexington Health IncGroup PAC ID 2567872070, 905 clinicians

Practice addresses (Care Compare)

146 E Hospital Dr
Suite 400
West Columbia, SC 29169-4800
Phone (803) 936-3300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.09 of 100Reported as group
Quality
68.87
Promoting interoperability
100
Improvement activities
40
Cost
78.11

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue16
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
86679SCMDSurgery Physician
57-022723OHMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington Health Inc Current Accepting new patients
Florida Hospital Medical Group Inc Surgery CurrentSince Sep 4, 2018 Accepting new patients
Lexington County Health Services District Inc Current Accepting new patients
Lexington Health Inc CurrentSince Sep 15, 2021 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Sep 4, 2018 Accepting new patients
Lexington Health Inc CurrentSince Sep 15, 2021 Accepting new patients
Lexington Health Inc Past Accepting new patients
Lexington County Health Services District, Inc. Past Accepting new patients

Locations

2100 Ocoee Apopka Rd
Ste 230
Apopka, FL 32703
Phone (407) 609-7392

201 N Park Ave
Ste 206
Apopka, FL 32703
Phone (321) 214-4133

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

3016 Longtown Commons Dr
Ste 210
Columbia, SC 29229
Phone (803) 936-3300

811 W Main St
Ste 101
Lexington, SC 29072
Phone (803) 936-7230

146 E Hospital Dr
Ste 400
West Columbia, SC 29169
Phone (803) 936-3300

Networks

  • Freedom Health HMO Network

Organizations & group practices 8

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 6

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": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1902232952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6069",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291716069",
            "telephone_number": "803-936-3300",
            "fax_number": "803-936-7735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 E HOSPITAL DR STE 400",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694800",
            "telephone_number": "803-936-3300",
            "fax_number": "803-936-7735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLY",
        "first_name": "COLLIN",
        "middle_name": "LOWELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-23",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "57-022723",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "86679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ctully147641@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "146 E Hospital Dr Ste 400",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

Verify at the official NPI Registry.