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EMMETT LYDON DO
NPI 1639017502
Student in an Organized Health Care Education/Training Program in North Charleston, SC

Active since March 23, 2026PECOS Enrolled
9330 MEDICAL PLAZA DR, NORTH CHARLESTON, SC 29406(843) 818-7083 Get Directions Write a Review

NPPES record last updated: March 23, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Emmett Lydon Do NPPES

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

EMMETT LYDON DO (NPI 1639017502) is an individual student in an organized health care education/training program in North Charleston, South Carolina and active in the NPI registry since March 2026. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639017502
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameEMMETT LYDONCredential: DO
Location Address9330 MEDICAL PLAZA DRNorth Charleston, SC 29406-9104
Mailing Address9225 University Blvd Ste E2bNorth Charleston, SC 29406-9149 · (843) 818-7083
Phone(843) 818-7083
Sole ProprietorNo
Enumeration DateMarch 23, 2026
NPPES CertifiedMarch 23, 2026
✔ NPI 1639017502 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
9330 MEDICAL PLAZA DR, North Charleston, SC 29406
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Emmett Lydon Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. RICHARD DALE BRINSON MSN, APRN, NP-C
Nurse Practitioner (Acute Care)
9330 MEDICAL PLAZA DR
NORTH CHARLESTON, SC 29406
Charleston County (843) 847-4595
DR. DARRYL EDWARD MCFARLAND MD
Internal Medicine (Critical Care Medicine)
9330 MEDICAL PLAZA DR
CHARLESTON, SC 29406
Charleston County (843) 797-7000
ROSSEN IVANOV KIRKOV MD
Emergency Medicine
9330 MEDICAL PLAZA DR
CHARLESTON, SC 29406
Charleston County (843) 797-7000
MORGAN ELISABETH HUNT
Student in an Organized Health Care Education/Training Program
9330 MEDICAL PLAZA DR
NORTH CHARLESTON, SC 29406
Charleston County (843) 797-7000
DR. ALLISON LUNDY MCCRAE MD
Surgery
9330 MEDICAL PLAZA DR
NORTH CHARLESTON, SC 29406
Charleston County (843) 797-7000
DR. SARAH CARTER PT, DPT
Physical Therapist
9330 MEDICAL PLAZA DR
NORTH CHARLESTON, SC 29406
Charleston County (843) 797-7000
DR. VINCENT PAUL GRZYWACZ II MD
Radiology (Radiation Oncology)
9330 MEDICAL PLAZA DR
CHARLESTON, SC 29406
Charleston County (843) 847-4571
MISBHA ANJUM MD
Student in an Organized Health Care Education/Training Program
9330 MEDICAL PLAZA DR
CHARLESTON, SC 29406
Charleston County (843) 847-5620

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 Emmett Lydon's NPI number?

The NPI number for Emmett Lydon is 1639017502. It was assigned to this individual provider in the NPPES registry on March 23, 2026.

Where is Emmett Lydon located?

Emmett Lydon practices at 9330 Medical Plaza Dr, North Charleston, SC 29406. The listed phone number is (843) 818-7083.

What is Emmett Lydon's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Emmett Lydon enrolled in Medicare?

Yes. Emmett Lydon is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Emmett Lydon was last updated on March 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.