Individual provider Active NPI

Lucas Traub Ribbens, MD

  • Psychiatry Physician
  • Charleston, SC
National Provider Identifier
1992437347
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
88340 Issued in SC
Practice address
2100 Charlie Hall Blvd
Charleston, SC 29414-5832
Phone
(843) 852-4100
NPI assigned
Jun 25, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 88340 SC Primary

Addresses

Primary practice location

2100 Charlie Hall Blvd
Charleston, SC 29414-5832

Mailing address

171 Ashley Ave
Charleston, SC 29425-8908

Other practice location 1

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-2300

Other practice location 2

1483 Tobias Gadson Blvd Ste 201
Charleston, SC 29407-4796
Phone (843) 745-5153

Other identifiers 1

IdentifierTypeStateIssuer
1760596480MedicaidSC

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
I20240919000551 SC Practitioner - Psychiatry 7810365236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Compass Carolina Health Systems PAGroup PAC ID 7214084870, 6 clinicians

Practice addresses (Care Compare)

2777 Speissegger Dr
Charleston, SC 29405-8229
Phone (843) 747-5830

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Carolina Health Systems PA Psychiatry CurrentSince Sep 2, 2024 Accepting new patients
Lowcountry Wellness Center LLC PastSince Sep 10, 2017 Accepting new patients

Locations

1065 NE 125th St
Ste 300
North Miami, FL 33161
Phone (305) 891-0050

1483 Tobias Gadson Blvd
Ste 201
Charleston, SC 29407
Phone (843) 745-5153

2777 Speissegger Dr
North Charleston, SC 29405
Phone (843) 266-7080

Organizations & group practices 2

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": "1656115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1992437347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 CHARLIE HALL BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145832",
            "telephone_number": "843-852-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "171 Ashley Ave",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294258908",
            "country_code": "US",
            "telephone_number": "843-792-2300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1483 Tobias Gadson Blvd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294074796",
            "country_code": "US",
            "telephone_number": "843-745-5153",
            "fax_number": "305-891-4228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIBBENS",
        "first_name": "LUCAS",
        "middle_name": "TRAUB",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-25",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "88340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760596480",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.