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LAKE MARION PRIMARY CARE
NPI 1912964479
Internal Medicine - Cardiovascular Disease in Manning, SC

Active since April 27, 2006
15 E HOSPITAL ST, MANNING, SC 29102(803) 435-2529(803) 435-4196 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Lake Marion Primary Care NPPES

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

LAKE MARION PRIMARY CARE (NPI 1912964479) is a healthcare organization registered as a cardiovascular disease in Manning, South Carolina and active in the NPI registry since April 2006. The organization lists Saundra Wallace, Administrator, as its authorized official.

NPPES Registry Identity

NPI1912964479
Entity TypeOrganization
Primary Taxonomy207RC0000X
Legal Business NameLAKE MARION PRIMARY CARE
Location Address15 E HOSPITAL STManning, SC 29102-3152
Mailing Address15 E Hospital StManning, SC 29102-3152 · (803) 435-2529 · Fax (803) 435-4196
Phone(803) 435-2529
Fax(803) 435-4196
Organization SubpartNo
Authorized OfficialSaundra WallaceAdministrator · (803) 435-2529
Enumeration DateApril 27, 2006
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
✔ NPI 1912964479 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License✔ Licensed in SC · 20345
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Also ListedFamily MedicineTaxonomy 207Q00000X · License 13275 (SC)

Other Identifiers 1

MedicaidGP2178SC

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

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

RAMON PROCTAN SY MD
Internal Medicine (Cardiovascular Disease)
15 E HOSPITAL ST
MANNING, SC 29102
Clarendon County (803) 435-2529
DANIELLE BOYCE SALDANA D.O.
Surgery
15 E HOSPITAL ST
MANNING, SC 29102
Clarendon County (803) 435-2822
MCLEOD PHYSICIAN ASSOCIATES II
Surgery
15 E HOSPITAL ST
MANNING, SC 29102
Clarendon County (803) 435-2822

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 Lake Marion Primary Care's NPI number?

The NPI number for Lake Marion Primary Care is 1912964479. It was assigned to this organization in the NPPES registry on April 27, 2006.

Where is Lake Marion Primary Care located?

Lake Marion Primary Care is located at 15 E Hospital St, Manning, SC 29102. The listed phone number is (803) 435-2529.

What is Lake Marion Primary Care's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

When was this NPI record last updated?

The NPPES record for Lake Marion Primary Care was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.