MEDICARE: ADVANTAGE INTEGRATED MEDICAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician
2	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1013669126
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANTAGE INTEGRATED MEDICAL

Provider Business Mailing Address
First Line	:	1926 S LAKE DR
Second Line	:
City	:	LEXINGTON
State	:	SC
Zip	:	29073-8282
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1926 S LAKE DR
Second Line	:
City	:	LEXINGTON
State	:	SC
Zip	:	29073-8282
Country	:	US
Telephone Number	:	803-462-5440
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	DAVID GOOLDY
Credential	:	DC
Telephone Number	:	803-462-5440

Provider Enumeration Date	:	01/20/2022
Last Update Date	:	01/20/2022

Similar Medicare Providers

1679560742 — THREE FOUNTAINS CHIROPRACTIC, INC.
Practice Location Address:

1926 S LAKE DR
LEXINGTON, SC
29073-8282

Practice Phone: 803-808-1897
Practice Fax:

1972590040 — DR. DAVID R GOOLDY DC
Practice Location Address:

1926 S LAKE DR
LEXINGTON, SC
29073-8282

Practice Phone: 803-808-1897
Practice Fax:

1992938054 — BARBER CHIROPRACTIC
Practice Location Address:

1926 S LAKE DR
LEXINGTON, SC
29073-8282

Practice Phone: 803-808-1897
Practice Fax:

1790058626 — SOUTH CAROLINA SPINE CARE, LLC
Practice Location Address:

1926 S LAKE DR
LEXINGTON, SC
29073-8282

Practice Phone: 803-429-7690
Practice Fax: 803-808-1297

1871907782 — DR. TIA ROBINSON APRN
Practice Location Address:

1070 S LAKE DR
LEXINGTON, SC
29073-3701

Practice Phone: 803-785-6666
Practice Fax:

1639031115 — CIARA HILL
Practice Location Address:

985 NATIVE RYE WAY
LEXINGTON, SC
29073-6206

Practice Phone: 803-878-0526
Practice Fax:

Directions to “ADVANTAGE INTEGRATED MEDICAL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.