Lacey Taylor Humphries (NPI# 1225586399, PAC ID# 9931484177) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1225586399 |
| PAC ID by PECOS | 9931484177 |
| Professional Enrollment ID | I20170330000858 |
| Full Name | Lacey Taylor Humphries |
| Organization Legal Name | CAPITOL UROLOGY, PA |
| Address |
3600 Forest Dr Suite 401 Columbia SC 29204-4046 |
| Phone Number | 8032516602 |
| Gender | F |
| Graduation Year | 2016 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 0648276444 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 420018 | PALMETTO HEALTH RICHLAND |
| Address | Phone | Organization |
|---|---|---|
| 2 Medical Park Rd, Suite 506, Columbia, SC 29203-6876 | 8035401000 | PALMETTO HEALTH-UNIVERSITY OF SOUTH CAROLINA MEDICAL GROUP |
| 3600 Forest Dr, Suite 401, Columbia, SC 29204-4046 | 8032516602 | CAPITOL UROLOGY, PA |
| 9 Richland Medical Park Dr, Columbia, SC 29203-6859 | PALMETTO HEALTH-UNIVERSITY OF SOUTH CAROLINA MEDICAL GROUP |
| Organization Legal Name | CAPITOL UROLOGY, PA |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Thomas B Edmunds | Urology | Capitol Urology, Pa | 3600 Forest Dr, Suite 401, Columbia, SC 29204-4046 |
| Leslie B Mcdill | Nurse Practitioner | Capitol Urology, Pa | 1333 Taylor St, 2b, Columbia, SC 29201-2945 |
| Street Address |
3600 FOREST DR SUITE 401 |
| City | COLUMBIA |
| State | SC |
| Zip | 29204-4046 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christopher Trong-linh Than | Family Medicine | Palmetto Health-university of South Carolina Medical Group | 3600 Forest Dr, Suite 300, Columbia, SC 29204-4057 |
| Kathryn Mills Hollins Lizarribar | Family Medicine | Palmetto Health-university of South Carolina Medical Group | 3600 Forest Dr, Suite 300, Columbia, SC 29204-4057 |
| Anna Forrest Mckie | Physician Assistant | Csc Aquisition, LLC | 3600 Forest Dr, Suite 400, Columbia, SC 29204-4057 |
| Jim Chungshan Chow | Dermatology | Csc Aquisition, LLC | 3600 Forest Dr, Suite 400, Columbia, SC 29204-4057 |
| Alfonso Gonzalez | Pathology | Csc Aquisition, LLC | 3600 Forest Dr, Suite 400, Columbia, SC 29204-4057 |
| Danna Hall Thompson | Family Medicine | Palmetto Health-university of South Carolina Medical Group | 3600 Forest Dr, Suite 300, Columbia, SC 29204-4057 |
| April S Mcneill | Physician Assistant | Csc Aquisition, LLC | 3600 Forest Dr, Suite 400, Columbia, SC 29204-4057 |
| Thomas B Edmunds | Urology | Capitol Urology, Pa | 3600 Forest Dr, Suite 401, Columbia, SC 29204-4046 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Erin Jaynes Belk | Nurse Practitioner | Providence Group Practices II LLC | 2001 Laurel St, Columbia, SC 29204-1018 |
| Benedict R Studnicka | Internal Medicine | Providence Physician Practices, LLC | 2001 Laurel St, Suite 300, Columbia, SC 29204-1018 |
| Charis P Taylor | Internal Medicine | Providence Physician Practices, LLC | 2001 Laurel St, Suite 300, Columbia, SC 29204-1018 |
| Brittany Winestock | Nurse Practitioner | Providence Group Practices II LLC | 2001 Laurel St, Columbia, SC 29204-1018 |
| Susan K Caudle | Physician Assistant | Providence Physician Practices, LLC | 2001 Laurel St, Suite 300, Columbia, SC 29204-1018 |
| Stephen Mullaney | Nurse Practitioner | Providence Physician Practices, LLC | 2001 Laurel St, Suite 300, Columbia, SC 29204-1018 |
| Ala Bianca Naomi Lucky | Nurse Practitioner | Providence Group Practices II LLC | 2001 Laurel St, Columbia, SC 29204-1018 |
| Kaitlin N Corwin | Physician Assistant | Providence Physician Practices, LLC | 2001 Laurel St, Suite 300, Columbia, SC 29204-1018 |
| Lanneau D Lide | Cardiovascular Disease (cardiology) | Providence Group Practices LLC | 2001 Laurel St, Columbia, SC 29204-1018 |
| Stephanie C Peterson | Physician Assistant | Providence Physician Practices, LLC | 2001 Laurel St, Suite 300, Columbia, SC 29204-1018 |
| Find all physicians in zip 29204 | |||
| City | COLUMBIA |
| Zip Code | 29204 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | COLUMBIA + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Lacey Taylor Humphries.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.