DR. KEITH WOODWARD LACKEY (NPI# 1154389815) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154389815 |
| Entity Type | Individual |
| Full Name | DR. KEITH WOODWARD LACKEY |
| Credential | MD |
| Practice Address |
615 Wesley Drive Suite 300 Charleston SC 29407 |
| Mailing Address |
Po Box 751649 Charlotte NC 28275-1649 |
| Practice Telephone | 8432664400 |
| Practice Fax Number | 8435770455 |
| Mailing Telephone | 8437891620 |
| Mailing Fax Number | 8437242440 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2015-10-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 15543 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | RR MEDICARE | 110105130 | 01 |
| SC | RR MEDICARE | 110232037 | 01 |
| SC | 155432 | 05 | |
| SC | RAILROAD MC ID-RSFPN | P00754364 | 01 |
| Street Address |
615 WESLEY DRIVE SUITE 300 |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083672745 | Robert William Cain | Internal Medicine | 615 Wesley Drive, Suite 300, Charleston, SC 29407 | 2006-05-03 |
| 1730131012 | William H Snyder | Internal Medicine | 615 Wesley Drive, Suite 200, Charleston, SC 29407 | 2006-05-16 |
| 1649222928 | Charles L Smith | Internal Medicine | 615 Wesley Drive, Suite 200, Charleston, SC 29407 | 2006-05-16 |
| 1134171440 | Cary S Hickman | Internal Medicine | 615 Wesley Drive, Suite 200, Charleston, SC 29407 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437763661 | Charleston Jaw Surgery | Oral & Maxillofacial Surgery | 846 St. Andrews Blvd., Charleston, SC 29407 | 2020-09-04 |
| 1780225128 | New Endeavors Counseling | Social Worker | 1 Carriage Lane Building E Suite 202, Charleston, SC 29407 | 2019-10-07 |
| 1770063158 | Katelyn Campbell | Psychologist | 1 Carriage Ln Ste 102, Charleston, SC 29407 | 2018-08-15 |
| 1164929956 | Anisha Gulati Md LLC | Psychiatry & Neurology | 925 Wappoo Rd., Suite F, Charleston, SC 29407 | 2018-04-09 |
| 1316459753 | David W Richardson | Dentist | 765 St. Andrews Blvd., Charleston, SC 29407 | 2017-10-25 |
| 1457874174 | Meca Mentality LLC | Chiropractor | 1106 St Andrews Blvd Suite A, Charleston, SC 29407 | 2017-07-25 |
| 1639609373 | Carolina Behavioral Specialists, LLC | Behavioral Analyst | 1529 Sam Rittenberg Blvd, Unit 1-b, Charleston, SC 29407 | 2017-06-15 |
| 1467991901 | Bernice Ladson | Registered Nurse | 75o Magnolia Road, Charleston, SC 29407 | 2017-02-16 |
| 1376991257 | Virginia Leigh Thomason | Counselor | 29 Leinbach Dr, Suite D2, Charleston, SC 29407 | 2016-06-01 |
| 1609221001 | Elinor Lee Smith | Counselor | 571 Savannah Hwy, Charleston, SC 29407 | 2016-05-04 |
| Find all providers in zip 29407 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972128221 | John Fincher Gist Bobo | Internal Medicine | 169 Ashley Ave Rm 202muh, Charleston, SC 29425-8905 | 2020-06-12 |
| 1831746874 | Roper Saint Francis Physicians Network | Internal Medicine | 615 Wesley Dr Ste 120, Charleston, SC 29407-7206 | 2019-08-23 |
| 1104486463 | Matthew Bruner | Internal Medicine | 162 Ashley Ave Rm 202, Charleston, SC 29425-8907 | 2019-06-19 |
| 1366001760 | Rayphael Sebastian Hardy | Internal Medicine | 169 Ashley Avenue Room 202 Main Hospital Msc333, Charleston, SC 29425 | 2019-06-10 |
| 1427617950 | Emily Suzanne Nyers | Internal Medicine | 169 Ashley Ave., Room 202 Main Hospital, Msc 333, Charleston, SC 29425 | 2019-06-09 |
| 1225697931 | Shenia Lorraine Singleton | Internal Medicine | 706 Tahoe St, Charleston, SC 29407-6629 | 2019-06-07 |
| 1871152520 | Elena Vlachos | Internal Medicine | 169 Ashley Aveneue Room 202 Main Hospital, Charleston, SC 29425-0001 | 2019-06-06 |
| 1750877890 | Mona Ali Haj | Internal Medicine | 96 Jonathan Lucas St Rm 202, Charleston, SC 29425-8900 | 2018-07-02 |
| 1538654025 | Megan Kathleen Veglia | Internal Medicine | 135 Rutledge Ave Fl 8, Charleston, SC 29425-8905 | 2018-06-27 |
| 1457881559 | Milad Cesar El Hajj | Internal Medicine | 96 Jonathan Lucas St Ste 807, Charleston, SC 29425-8900 | 2017-06-13 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 29407 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.