NPIMap

Individual provider Active NPI

Lidia C Baldea, MD

  • Internal Medicine Physician
  • Greenville, SC
National Provider Identifier
1952321341
Registry record updated Nov 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
27049 Issued in SC
Practice address
10 Enterprise Blvd Ste 111
Covenant Internal Medicine
Greenville, SC 29615-3534
Phone
(864) 365-0200
Fax
(864) 365-0205
NPI assigned
Jul 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 27049 SC Primary

Addresses

Primary practice location

10 Enterprise Blvd Ste 111
Covenant Internal Medicine
Greenville, SC 29615-3534

Mailing address

PO Box 743294
Atlanta, GA 30374-3294
Phone (864) 365-0020

Other identifiers 1

IdentifierTypeStateIssuer
270496MedicaidSC

Other names 1

  • Lidia C Rollison Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070815000200 SC Practitioner - Internal Medicine 8123110525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Francis Physician Services IncGroup PAC ID 6608826821, 106 clinicians

Practice addresses (Care Compare)

1200 Brookfield Blvd
Suite 400B
Greenville, SC 29607-6583
Phone (864) 605-3721

Hospital & facility affiliations

  • NHC Homecare Laurens Home health agency, Clinton, SC, CCN 427079
  • St Francis Hospital Home Care Home health agency, Simpsonville, SC, CCN 427049
  • St Francis-Downtown Hospital, Greenville, SC, CCN 420023
  • Prisma Health Patewood Hospital Hospital, Greenville, SC, CCN 420102
  • Prisma Health Greer Memorial Hospital Hospital, Spartanburg, SC, CCN 420033

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27049SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Physician Services Inc Internal Medicine CurrentSince Oct 1, 2016 Accepting new patients
St Francis Physician Services Inc Internal Medicine CurrentSince Oct 1, 2016 Accepting new patients
St Francis Physician Services Inc Internal Medicine Past Accepting new patients

Locations

10 Enterprise Blvd
Ste 111
Greenville, SC 29615
Phone (864) 365-0200

1200 Brookfield Blvd
Ste 400B
Greenville, SC 29607
Phone (864) 605-3721

Interoperability endpoints

  • Direct secure messaging: lbaldea1149269@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 and National Provider Directory roles.

Hospital & facility affiliations 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480291200000",
    "number": "1952321341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743294",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743294",
            "telephone_number": "864-365-0020",
            "fax_number": "864-365-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 ENTERPRISE BLVD STE 111",
            "address_2": "COVENANT INTERNAL MEDICINE",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153534",
            "telephone_number": "864-365-0200",
            "fax_number": "864-365-0205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDEA",
        "first_name": "LIDIA",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2016-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "27049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270496",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIDIA",
            "last_name": "ROLLISON",
            "middle_name": "C",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.