CHARLESTON MEDICAL ASSOCIATES (NPI# 1376033829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376033829 |
| Entity Type | Organization |
| Organization Name | CHARLESTON MEDICAL ASSOCIATES |
| Other Organization Name | GENERATIONS PEDIATRICS AND INTERNAL MEDICINE |
| Practice Address |
1483 Tobias Gadson Blvd Ste 101 Charleston SC 29407-4795 |
| Practice Telephone | 8434051110 |
| Mailing Telephone | 8434051110 |
| Enumeration Date | 2018-05-10 |
| Last Update Date | 2018-05-10 |
| Authorized Official Name | DR. MATTHEW JUSTICE KORNEGAY (MANAGING PARTNER) |
| Authorized Official Telephone | 8436147953 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | CHARLESTON MEDICAL ASSOCIATES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 311442 | 05 |
| Other Name | Type Code |
|---|---|
| Generations Pediatrics and Internal Medicine | Doing Business As Name - Organization |
| Street Address |
1483 TOBIAS GADSON BLVD STE 101 |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29407-4795 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922042654 | Matthew Justice Kornegay | Internal Medicine | 1483 Tobias Gadson Blvd Ste 101, Charleston, SC 29407-4795 | 2006-06-15 |
| 1598263097 | Plantation Pediartics, LLC | Internal Medicine | 1483 Tobias Gadson Blvd Ste 101, Charleston, SC 29407-4795 | 2018-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437763661 | Charleston Jaw Surgery | Oral & Maxillofacial Surgery | 846 St. Andrews Blvd., Charleston, SC 29407 | 2020-09-04 |
| 1780225128 | New Endeavors Counseling | Social Worker | 1 Carriage Lane Building E Suite 202, Charleston, SC 29407 | 2019-10-07 |
| 1770063158 | Katelyn Campbell | Psychologist | 1 Carriage Ln Ste 102, Charleston, SC 29407 | 2018-08-15 |
| 1164929956 | Anisha Gulati Md LLC | Psychiatry & Neurology | 925 Wappoo Rd., Suite F, Charleston, SC 29407 | 2018-04-09 |
| 1316459753 | David W Richardson | Dentist | 765 St. Andrews Blvd., Charleston, SC 29407 | 2017-10-25 |
| 1457874174 | Meca Mentality LLC | Chiropractor | 1106 St Andrews Blvd Suite A, Charleston, SC 29407 | 2017-07-25 |
| 1639609373 | Carolina Behavioral Specialists, LLC | Behavioral Analyst | 1529 Sam Rittenberg Blvd, Unit 1-b, Charleston, SC 29407 | 2017-06-15 |
| 1467991901 | Bernice Ladson | Registered Nurse | 75o Magnolia Road, Charleston, SC 29407 | 2017-02-16 |
| 1376991257 | Virginia Leigh Thomason | Counselor | 29 Leinbach Dr, Suite D2, Charleston, SC 29407 | 2016-06-01 |
| 1609221001 | Elinor Lee Smith | Counselor | 571 Savannah Hwy, Charleston, SC 29407 | 2016-05-04 |
| Find all providers in zip 29407 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447758032 | Crs Eyecare Services, Inc. | Clinic/Center | 112 Rutledge Ave Ste A, Charleston, SC 29401-1333 | 2018-01-29 |
| 1760829519 | Health First | Clinic/Center | 1115 Savannah Hwy, Charleston, SC 29407-7805 | 2013-06-03 |
| 1235108721 | Charleston Internal Medicine, LLC | Clinic/Center | 537 Folly Rd, Charleston, SC 29412-3007 | 2006-03-16 |
| 1174520068 | Jeffery L Deal | Clinic/Center | 1938 Charlie Hall Blvd Unit B, Charleston, SC 29414-6099 | 2005-07-07 |
| 1033778642 | Kanawha County Emergency Ambulance Authority Health and Wellness Board | Clinic/Center | 601 Brooks St, Charleston, WV 25301-1319 | 2019-06-07 |
| 1528560083 | Kanawha County Emergency Ambulance Authority | Clinic/Center | 601 Brooks St, Charleston, WV 25301-1319 | 2018-03-01 |
| 1639604929 | Lowcountry Wellness Center LLC | Clinic/Center | 1941 Savage Rd Ste 100e, Charleston, SC 29407-4788 | 2017-04-25 |
| 1770905952 | Charleston Primary Care Inc. | Clinic/Center | 506 W Lincoln Ave, Suite 200, Charleston, IL 61920-2453 | 2014-01-07 |
| 1336577238 | Western Arkansas Primary Care | Clinic/Center | 2617 E Main St, Charleston, AR 72933-9637 | 2013-10-31 |
| 1417389594 | Building Blocks Family Chiropractic. LLC | Clinic/Center | 1001 Physicians Dr, Charleston, SC 29414-5746 | 2013-07-31 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 29407 |
Please comment or provide details below to improve the information on CHARLESTON MEDICAL ASSOCIATES.
| 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.