Individual provider Active NPI

Lauren Clifford Lucas, M.D.

  • Pediatrics Physician
  • Charleston, SC
National Provider Identifier
1912389628
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD38499 Issued in SC
Practice address
1243 Savannah Hwy Ste B
Charleston, SC 29407-7817
Phone
(843) 556-8110
Fax
(843) 556-8112
NPI assigned
Jun 18, 2015
Last updated
Sep 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD38499 SC Primary

Addresses

Primary practice location

1243 Savannah Hwy Ste B
Charleston, SC 29407-7817

Mailing address

1243 Savannah Hwy Ste B
Charleston, SC 29407-7817
Phone (438) 556-8110

Other identifiers 1

IdentifierTypeStateIssuer
384998MedicaidSC

Other names 1

  • Lauren Clifford Lucas Professional name

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
I20210708001065 SC Practitioner - Pediatric Medicine 6608186440 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD38499SCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Pediatric Associates, P.a. Pediatrics CurrentSince Jul 1, 2021 Accepting new patients
Carolina Family Care, Inc Pediatrics PastSince Sep 11, 2022 Accepting new patients
Parkwood Pediatric Group PA Pediatrics Past Accepting new patients

Locations

2051 Charlie Hall Blvd
Charleston, SC 29414
Phone (843) 573-2535

2067 Charlie Hall Blvd
Charleston, SC 29414
Phone (843) 573-2535

1952 Long Grove Dr
Ste 202
Mt Pleasant, SC 29464
Phone (843) 573-2535

2015 2nd Ave
Ste 101
Summerville, SC 29486
Phone (843) 573-2535

Interoperability endpoints

  • Direct secure messaging: llucas1252645@direct.bsmhealth.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1912389628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1243 SAVANNAH HWY STE B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077817",
            "telephone_number": "438-556-8110",
            "fax_number": "843-556-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1243 SAVANNAH HWY STE B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077817",
            "telephone_number": "843-556-8110",
            "fax_number": "843-556-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "LAUREN",
        "middle_name": "CLIFFORD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-18",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "MD38499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "384998",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "LUCAS",
            "middle_name": "CLIFFORD",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.