SEASIDE FAMILY MEDICINE, LLC (NPI# 1043707557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043707557 |
| Entity Type | Organization |
| Organization Name | SEASIDE FAMILY MEDICINE, LLC |
| Practice Address |
1341 College Park Rd # A Summerville SC 29486 |
| Mailing Address |
1341 College Park Rd # A Summerville SC 29486-8635 |
| Practice Telephone | 8434000028 |
| Practice Fax Number | 8437908449 |
| Mailing Telephone | 8434000028 |
| Mailing Fax Number | 8437908449 |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2018-08-13 |
| Authorized Official Name | AMANDA E. MCALLISTER (NP, OWNER) |
| Authorized Official Telephone | 8434000028 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
18442 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | NP2488 | 05 |
| Street Address |
1341 COLLEGE PARK RD # A |
| City | SUMMERVILLE |
| State | SC |
| Zip Code | 29486 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952921454 | Cooper River Pediatric Therapy LLC | Speech-Language Pathologist | 119 Callibluff Dr, Summerville, SC 29486 | 2020-04-24 |
| 1750928164 | Tidewater Eyecare, LLC | Optometrist | 301 Front St., Summerville, SC 29486 | 2019-12-04 |
| 1366086621 | Tgd-summerville LLC | Dentist | 604-a Nexton Square Dr, Summerville, SC 29486 | 2019-10-30 |
| 1336783604 | Tdsp-summerville LLC | Dentist | 604-b Nexton Square Dr, Summerville, SC 29486 | 2019-10-30 |
| 1699256081 | Denise Michelle Richardson | Speech-Language Pathologist | 201 School House Ln, Summerville, SC 29486 | 2018-08-24 |
| 1497243588 | Charleston Ent Associates, LLC | Non-Pharmacy Dispensing Site | 2205 2nd Avenue, Summerville, SC 29486 | 2018-04-25 |
| 1023511144 | Grace Physical Therapy and Sports Rehab At Nexton | Clinic/Center | 5500 Front St, Suite 201, Summerville, SC 29486 | 2018-03-15 |
| 1295253086 | Dillon Robert Gregory | Specialist/Technologist | 313 Springdale Ct., Summerville, SC 29486 | 2017-09-01 |
| 1013456987 | Sfd Kids LLC | Dentist | 108 Parish Farms Drive, Summerville, SC 29486 | 2017-02-13 |
| 1316333529 | Joanna Hedin | Social Worker | 89b Old Trolley Rd., Suite 207, Summerville, SC 29486 | 2015-04-14 |
| Find all providers in zip 29486 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932652856 | Medprimary LLC | Family Medicine | 103b Harth Pl, Summerville, SC 29485-8107 | 2016-07-27 |
| 1265893705 | Roper Saint Francis Physicians Network | Family Medicine | 1525 Old Trolley Rd Ste H, Summerville, SC 29485-8928 | 2016-03-11 |
| 1740647650 | Palmetto Primary Care Physicians, LLC | Family Medicine | 201 Sigma Dr, Ste 100, Summerville, SC 29486-7715 | 2016-01-22 |
| 1043654700 | Merritt Stanley Huber IIi | Family Medicine | 2000 1st Avenue, Summerville, SC 29486 | 2013-04-24 |
| 1982048062 | Summerville Primary Care | Family Medicine | 299-a Midland Parkway, Summerville, SC 29485 | 2013-04-19 |
| 1710274295 | Jennifer R. Stolin | Family Medicine | 90 Springview Ln Ste A, Summerville, SC 29485-8153 | 2011-07-05 |
| 1497075733 | Palmetto Primary Care Physicians | Family Medicine | 300 W 4th North St, Summerville, SC 29483-6550 | 2010-06-09 |
| 1265667828 | Christina Douglass | Family Medicine | 11766 Hwy 27 North, Summerville, GA 30747 | 2009-05-26 |
| 1194986299 | Marie E Neilsen | Family Medicine | 9500 Dorchester Rd Ste 362, Summerville, SC 29485-4304 | 2008-06-20 |
| 1407992803 | Steven John Lenes | Family Medicine | 9995 Jamison Rd., Summerville, SC 29485 | 2007-01-30 |
| Find all providers in SUMMERVILLE | ||||
| City | SUMMERVILLE |
| Zip Code | 29486 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.