Individual provider Active NPI

Lyle G Walsh, M.D.

  • Internal Medicine Physician
  • North Charleston, SC
National Provider Identifier
1962464875
Registry record updated Jul 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20374 Issued in SC
Practice address
8992 University Blvd Ste 300
North Charleston, SC 29406-8104
Phone
(843) 876-8279
NPI assigned
Apr 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2012

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 20374 SC Primary

Addresses

Primary practice location

8992 University Blvd Ste 300
North Charleston, SC 29406-8104

Mailing address

PO Box 602108
Charlotte, NC 28260-2108
Phone (843) 792-6200

Other identifiers 2

IdentifierTypeStateIssuer
110206688OtherSCRAILROAD MEDICARE ID#
203746MedicaidSC

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
I20101122000038 SC Practitioner - Internal Medicine 5092629626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.96 of 100Reported as group
Quality
89.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20374SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Family Care, Inc CurrentSince May 27, 2012 Accepting new patients
Low Country Internal Medicine of SC, P.a. Internal Medicine Current Accepting new patients
Carolina Family Care, Inc Internal Medicine CurrentSince May 27, 2012 Accepting new patients
Coastal Carolina Primary Care, LLC Past Accepting new patients

Locations

1208 Two Island Ct
Mt Pleasant, SC 29466
Phone (843) 884-6653

2845 Tricom St
North Charleston, SC 29406
Phone (843) 797-1770

8992 University Blvd
Ste 300
North Charleston, SC 29406
Phone (843) 876-8279

8471 Resolute Way
North Charleston, SC 29420
Phone (843) 876-2879

Organizations & group practices 4

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": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341446400000",
    "number": "1962464875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602108",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602108",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8992 UNIVERSITY BLVD STE 300",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294068104",
            "telephone_number": "843-876-8279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "LYLE",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2012-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "20374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE ID#",
            "identifier": "110206688",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203746",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

Verify at the official NPI Registry.