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PRIME CARE OF THE LOWER PEE DEE, LLC
NPI 1437692407
Clinic/Center - Multi-Specialty in Lake City, SC

Active since November 23, 2016
263 KELLEY ST STE 100, LAKE CITY, SC 29560(843) 394-8274(843) 394-1604 Get Directions Write a Review

NPPES record last updated: November 23, 2016. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Prime Care Of The Lower Pee Dee, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRIME CARE OF THE LOWER PEE DEE, LLC (NPI 1437692407) is a healthcare organization registered as a multi-specialty in Lake City, South Carolina and active in the NPI registry since November 2016. The organization lists Tyrone Delmar Wallace, Owner, as its authorized official.

NPPES Registry Identity

NPI1437692407
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NamePRIME CARE OF THE LOWER PEE DEE, LLC
Location Address263 KELLEY ST STE 100Lake City, SC 29560-2472
Mailing Address263 Kelleyst Ste 100Lake City, SC 29560 · (843) 394-8274 · Fax (843) 394-1604
Phone(843) 394-8274
Fax(843) 394-1604
Organization SubpartNo
Authorized OfficialTyrone Delmar WallaceOwner · (843) 394-8274
Enumeration DateNovember 23, 2016
✔ NPI 1437692407 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
License✔ Licensed in SC · SC 1873
263 KELLEY ST STE 100, Lake City, SC 29560
Open in Google Maps ↗

Other Identifiers 2

MedicaidCH1873SC
Medicare OSCAR/certificationU533720281SC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Prime Care Of The Lower Pee Dee, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Prime Care Of The Lower Pee Dee, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Tyrone Wallace, DC
Chiropractic
NPI 1780633420
263 KELLEY ST STE 100
Lake City, SC 29560
(843) 394-8274
Same address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prime Care Of The Lower Pee Dee, LLC's NPI number?

The NPI number for Prime Care Of The Lower Pee Dee, LLC is 1437692407. It was assigned to this organization in the NPPES registry on November 23, 2016.

Where is Prime Care Of The Lower Pee Dee, LLC located?

Prime Care Of The Lower Pee Dee, LLC is located at 263 Kelley St Ste 100, Lake City, SC 29560. The listed phone number is (843) 394-8274.

What is Prime Care Of The Lower Pee Dee, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Is Prime Care Of The Lower Pee Dee, LLC enrolled in Medicare?

Yes. Prime Care Of The Lower Pee Dee, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Prime Care Of The Lower Pee Dee, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Prime Care Of The Lower Pee Dee, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Prime Care Of The Lower Pee Dee, LLC accept?

Health plans from Molina Healthcare list Prime Care Of The Lower Pee Dee, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Prime Care Of The Lower Pee Dee, LLC was last updated on November 23, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.