Individual provider Active NPI

Michael Dorian Lawhead, MD

  • Emergency Medicine Physician
  • Columbia, SC
National Provider Identifier
1972511236
Registry record updated Jun 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
11967 Issued in SC
Practice address
100 Palmetto Health Pkwy
Suite 104
Columbia, SC 29212-1753
Phone
(803) 434-5668
Fax
(803) 434-5669
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 11967 SC Primary

Addresses

Primary practice location

100 Palmetto Health Pkwy
Suite 104
Columbia, SC 29212-1753

Mailing address

PO Box 402145
Atlanta, GA 30384-2145
Phone (803) 296-7305

Other identifiers 1

IdentifierTypeStateIssuer
119678MedicaidSC

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
I20040330000842 SC Practitioner - Emergency Medicine 8224020573 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11967SCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Health Emergency Medicine CurrentSince Jun 8, 2014 Accepting new patients
Prisma Health-Midlands Current Accepting new patients
East Cooper Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
Palmetto Health Past Accepting new patients
Palmetto Health Past Accepting new patients

Locations

100 Palmetto Health Pkwy
Ste 104
Columbia, SC 29212
Phone (803) 434-5668

Organizations & group practices 5

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402876800000",
    "number": "1972511236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 402145",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303842145",
            "telephone_number": "803-296-7305",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PALMETTO HEALTH PKWY",
            "address_2": "SUITE 104",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292121753",
            "telephone_number": "803-434-5668",
            "fax_number": "803-434-5669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWHEAD",
        "first_name": "MICHAEL",
        "middle_name": "DORIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2014-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "11967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119678",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.