| Lake City Family Medicine | |
|
334 Mercy St Lake City SC 29560-2332 | |
| (843) 374-8380 | |
| (843) 374-5111 |
| Full Name | Lake City Family Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 334 Mercy St, Lake City, South Carolina |
| Authorized Official Name and Position | Rhonda M Robinson (CLINIC COORDINATOR) |
| Authorized Official Contact | 8433742036 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake City Family Medicine 258 N Ron Mcnair Blvd Lake City SC 29560-2462 Ph: (843) 374-2036 | Lake City Family Medicine 334 Mercy St Lake City SC 29560-2332 Ph: (843) 374-8380 |
| NPI Number | 1902903222 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 11/17/2008 |
| Medicare PECOS PAC ID | 6608802152 |
|---|---|
| Medicare Enrollment ID | O20050808000493 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902903222 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | RHC145 (South Carolina) | Primary |
| Provider Name | Samuel William Polen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194721076 PECOS PAC ID: 1456257955 Enrollment ID: I20031208000252 |
| Provider Name | Stephen W Askins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528088762 PECOS PAC ID: 7416998497 Enrollment ID: I20050519000854 |
| Provider Name | Daniel E Decamps |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669578373 PECOS PAC ID: 9032148259 Enrollment ID: I20050809000034 |
| Provider Name | David W Moon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417053133 PECOS PAC ID: 6204865421 Enrollment ID: I20050809000040 |
| Provider Name | James J Thomy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376649004 PECOS PAC ID: 5597758094 Enrollment ID: I20050809000046 |
| Provider Name | William Clark Griggs |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457376055 PECOS PAC ID: 3072597517 Enrollment ID: I20050809000082 |
| Provider Name | Steven Mcdonell Halus |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083610976 PECOS PAC ID: 2365473196 Enrollment ID: I20050822001104 |
| Provider Name | Nabil Abdalla Fam |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1700834710 PECOS PAC ID: 2567487291 Enrollment ID: I20051011000961 |
| Provider Name | Timothy Ronald Wagner |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1306899539 PECOS PAC ID: 0749207306 Enrollment ID: I20051102000239 |
| Provider Name | Johnny W Trogdon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336183409 PECOS PAC ID: 5496778524 Enrollment ID: I20060104000535 |
| Provider Name | Edwin L Gandy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871577478 PECOS PAC ID: 5698782951 Enrollment ID: I20060310000196 |
| Provider Name | Valda Lee Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790749851 PECOS PAC ID: 6204929912 Enrollment ID: I20070911000216 |
| Provider Name | David C Smith |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1275662421 PECOS PAC ID: 1254427024 Enrollment ID: I20071010000440 |
| Provider Name | Samuel C Covington |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063694461 PECOS PAC ID: 8022193267 Enrollment ID: I20080311000754 |
| Provider Name | David Kent Wright |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346200581 PECOS PAC ID: 7517927262 Enrollment ID: I20080530000291 |
| Provider Name | Steven Murrell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457540445 PECOS PAC ID: 0042344475 Enrollment ID: I20101109000786 |
| Provider Name | Toney Graham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841490869 PECOS PAC ID: 9234324369 Enrollment ID: I20101115000324 |
| Provider Name | Erik Dehlinger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073519542 PECOS PAC ID: 9739341512 Enrollment ID: I20120425000150 |
| Provider Name | Adebola Kolawole Adekanmbi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1609921212 PECOS PAC ID: 8123911914 Enrollment ID: I20120917000399 |
| Provider Name | Mark S Pack |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1952395709 PECOS PAC ID: 3173613676 Enrollment ID: I20130612000511 |
| Provider Name | Frank Foster Martin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619983798 PECOS PAC ID: 0648417980 Enrollment ID: I20131205001584 |
| Provider Name | Jamie G Spicer |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1619224409 PECOS PAC ID: 6709002322 Enrollment ID: I20140716002493 |
| Provider Name | David E Shupe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306192372 PECOS PAC ID: 5799901047 Enrollment ID: I20140723001416 |
| Provider Name | Steven H Nathanson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821040072 PECOS PAC ID: 6002719465 Enrollment ID: I20141006002165 |
| Provider Name | Ryan Mackenzie Connor |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1205274693 PECOS PAC ID: 8820219363 Enrollment ID: I20141024002143 |
| Provider Name | Frankie H White |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548608813 PECOS PAC ID: 0547582561 Enrollment ID: I20141202002199 |
| Provider Name | Bryan Wayne Howington |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184062416 PECOS PAC ID: 8426370008 Enrollment ID: I20141210001224 |
| Provider Name | Jason F Heilemann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922446970 PECOS PAC ID: 4082938758 Enrollment ID: I20150129000637 |
| Provider Name | Andre St Christopher Dyer |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1982022638 PECOS PAC ID: 6204147762 Enrollment ID: I20150624002313 |
| Provider Name | Lamar Marquis Ward |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1437568706 PECOS PAC ID: 7012214455 Enrollment ID: I20160329002799 |
| Provider Name | Tareq Haidary |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1356754154 PECOS PAC ID: 9032416110 Enrollment ID: I20160526000312 |
| Provider Name | Lisa Lanning |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023207784 PECOS PAC ID: 2062596927 Enrollment ID: I20160526002481 |
| Provider Name | Ashley Nicole Denmark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912388943 PECOS PAC ID: 6406135078 Enrollment ID: I20161122002485 |
| Provider Name | Kinzie Barton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609258243 PECOS PAC ID: 5597062968 Enrollment ID: I20161212001861 |
| Provider Name | Lauren Shurtliff |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164803193 PECOS PAC ID: 2668770868 Enrollment ID: I20161220001996 |
| Provider Name | Garrett Barton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518349158 PECOS PAC ID: 0648577023 Enrollment ID: I20161221001813 |
| Provider Name | Brooke Howell Perugini |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538540562 PECOS PAC ID: 0941599013 Enrollment ID: I20170109000680 |
| Provider Name | Chloe Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467992511 PECOS PAC ID: 8527336312 Enrollment ID: I20170620002146 |
| Provider Name | Karianne M Yates |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982085916 PECOS PAC ID: 5092013292 Enrollment ID: I20170725000182 |
| Provider Name | Timothy Kwiatkowski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1689661761 PECOS PAC ID: 3678505591 Enrollment ID: I20171120001209 |
| Provider Name | Nicole Joyner-powell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376072496 PECOS PAC ID: 2567732027 Enrollment ID: I20181106003173 |
| Provider Name | Heather Louise Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710305016 PECOS PAC ID: 5597005793 Enrollment ID: I20190326002292 |
| Provider Name | Daniel Mccorry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528598513 PECOS PAC ID: 7416227848 Enrollment ID: I20190604000534 |
| Provider Name | Akal Saagu Zeleke |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1932639242 PECOS PAC ID: 8921378027 Enrollment ID: I20191001001431 |
| Provider Name | Cody Clarke Anderson |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1871023960 PECOS PAC ID: 5193091254 Enrollment ID: I20201215000393 |
| Provider Name | Virginia M Ferguson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588197057 PECOS PAC ID: 0345570008 Enrollment ID: I20220317001381 |
Musc Health Primary Care - Ron Mcnair Blvd Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 276 N Ron Mcnair Blvd, Lake City, SC 29560 Phone: 843-792-1414 | |
Palmetto Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 330 Mercy St, Lake City, SC 29560 Phone: 843-374-9355 Fax: 843-374-9358 | |
East Main Medical Services, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 238 E Main St, Lake City, SC 29560 Phone: 843-374-7020 Fax: 843-374-7021 | |
Hopehealth School Base Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 652 N Matthews Rd, Lake City, SC 29560 Phone: 843-667-9414 Fax: 843-374-2713 | |
Carolinas Medical Alliance Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 John St, Lake City, SC 29560 Phone: 843-394-2031 | |
Live Oak Medical Center, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 148 Sauls St., Lake City, SC 29560 Phone: 843-687-0435 | |
Lake City Family Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 901 N Matthews Rd, Lake City, SC 29560 Phone: 843-374-8380 Fax: 843-374-5247 |