JACOB LUKE WAYLAND (NPI# 1164943213) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164943213 |
| Entity Type | Individual |
| Full Name | JACOB LUKE WAYLAND |
| Credential | MD |
| Practice Address |
Lexington Medical Center-emergency Medicine Dept 2720 Sunset Blvd West Columbia SC 29169 |
| Mailing Address |
470 Hulon Ln West Columbia SC 29169-4841 |
| Practice Telephone | 8037912000 |
| Mailing Telephone | 8037912000 |
| Mailing Fax Number | 8034343946 |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2020-10-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 51190 | SC | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | LL51190 | SC | Allopathic & Osteopathic Physicians |
| Street Address |
LEXINGTON MEDICAL CENTER-EMERGENCY MEDICINE DEPT 2720 SUNSET BLVD |
| City | WEST COLUMBIA |
| State | SC |
| Zip Code | 29169 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457960726 | Jerry Scott Oreilly | Physical Therapy Assistant | 100 Dreher Rd, Suite 100, West Columbia, SC 29169 | 2020-07-23 |
| 1134759921 | A&m Medical, LLC | Durable Medical Equipment & Medical Supplies | 1053 Sunset Boulevard, West Columbia, SC 29169 | 2020-01-21 |
| 1750946067 | First Physical Therapy, LLC | Clinic/Center | 100 Dreher Rd., Suite 100, West Columbia, SC 29169 | 2019-05-02 |
| 1295217545 | Tynaka Kwans Wilson | Nurse Practitioner | Sc House Calls Inc, 1053 Center Street, West Columbia, SC 29169 | 2018-09-04 |
| 1588183826 | Kimberly Jane Jennings | Registered Nurse | 1052 Center Street, Sc House Calls Inc, West Columbia, SC 29169 | 2017-09-19 |
| 1740721232 | Heather Detwiler | Physical Therapy Assistant | 2705 Leaphart Rd., Carolina Gardens, West Columbia, SC 29169 | 2017-03-16 |
| 1588110761 | Virginia I Hall | Nurse Practitioner | 2720 Susnet Blvd, West Columbia, SC 29169 | 2016-08-29 |
| 1215395744 | Stacey Khalifa | Social Worker | 160 Medical Cir Fl 1, West Columbia, SC 29169 | 2016-01-28 |
| 1407252331 | Sandy Frye Boone | Counselor | 2318 Sunset Blvd # 2a, West Columbia, SC 29169 | 2014-11-04 |
| 1497163547 | Marie Jose Moubarak | Pediatrics | 407 N Brown St, West Columbia, SC 29169 | 2014-07-31 |
| Find all providers in zip 29169 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922366418 | Elva Stinson | Emergency Medicine | 1244 Boston Ave, West Columbia, SC 29170-2124 | 2012-05-02 |
| 1750352563 | Alfred Ricks Jr. | Emergency Medicine | 2142 Riverside Dr, West Columbia, TX 77486-9642 | 2006-01-30 |
| 1588653216 | Paul B Shahbahrami | Emergency Medicine | 2720 Sunset Blvd., West Columbia, SC 29169 | 2005-10-15 |
| 1962002915 | Lexington Health Inc | Emergency Medicine | 2720 Sunset Blvd, West Columbia, SC 29169-4810 | 2020-10-29 |
| 1528589827 | John Lowell Montgomery | Emergency Medicine | 2720 Sunset Blvd, Emergency Medicine Department, West Columbia, SC 29169 | 2017-06-28 |
| 1245764661 | Xinwei Liu | Emergency Medicine | 2720 Sunset Blvd, West Columbia, SC 29169-4810 | 2017-04-12 |
| 1215382296 | Daniel Lee Johnson | Emergency Medicine | 2720 Sunset Blvd, West Columbia, SC 29169-4810 | 2016-04-27 |
| 1114314465 | David A Kranc | Emergency Medicine | 2720 Sunset Blvd, West Columbia, SC 29169 | 2015-04-23 |
| 1295140259 | Harold Andrew Hall | Emergency Medicine | 2720 Sunset Blvd, West Columbia, SC 29169-4810 | 2014-06-27 |
| 1790198018 | Jared R Stone | Emergency Medicine | 2720 Sunset Blvd, West Columbia, SC 29169 | 2014-06-04 |
| Find all providers in WEST COLUMBIA | ||||
| City | WEST COLUMBIA |
| Zip Code | 29169 |
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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.