LIBERTY DOCTORS, LLC (NPI# 1376854406) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376854406 |
| Entity Type | Organization |
| Organization Name | LIBERTY DOCTORS, LLC |
| Other Organization Name | MOBILE MEDICAL CONSULTANTS |
| Practice Address |
8761 Dorchester Rd Suite 230 North Charleston SC 29420-7322 |
| Mailing Address |
Po Box 13955 Charleston SC 29422-3955 |
| Practice Telephone | 8434712273 |
| Practice Fax Number | 8433778180 |
| Mailing Telephone | 8432258304 |
| Mailing Fax Number | 8432253549 |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2016-10-21 |
| Authorized Official Name | MRS. SARA ELIZABETH MAYNOR-HARDY (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 8432258320 |
| Is Organization Subpart | Y |
| Parent Organization Name | LIBERTY DOCTORS, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
27193 | SC | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP6738 | 05 |
| Other Name | Type Code |
|---|---|
| Mobile Medical Consultants | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821443896 | Liberty Doctors, LLC | Family Medicine | 9275 D Medical Plaza Dr., North Charleston, SC 29406 | 2016-04-27 |
| 1144421330 | Liberty Doctors, LLC | Family Medicine | 1405 Ben Sawyer Blvd, Ste 105, Mt Pleasant, SC 29464 | 2007-05-29 |
| 1508928656 | Liberty Doctors, LLC | Specialist | 6518 Dorchester Rd Ste B, Charleston, SC 29418-5100 | 2006-12-15 |
| 1053954909 | Liberty Doctors, LLC | Family Medicine | 297 Seven Farms Dr Ste 202, Daniel Island, SC 29492-7553 | 2019-10-23 |
| 1194380162 | Liberty Doctors, LLC | Internal Medicine | 2270 Ashley Crossing Dr Ste 165, Charleston, SC 29414-5865 | 2019-05-06 |
| 1588119556 | Liberty Doctors, LLC | Pediatrics | 215 Town Creek Rd, Aiken, SC 29803-5843 | 2016-08-19 |
| 1689129652 | Liberty Doctors, LLC | Family Medicine | 21 Gamecock Ave, Charleston, SC 29407-3368 | 2016-08-19 |
| 1689051369 | Liberty Doctors, LLC | Family Medicine | 418 Folly Rd Ste A, Charleston, SC 29412-2625 | 2015-05-01 |
| 1881639862 | Liberty Doctors, LLC | Family Medicine | 1483 Tobias Gadson Blvd, Suite 206, Charleston, SC 29407-8702 | 2006-06-16 |
| 1376593350 | Liberty Doctors, LLC | Specialist | 100 Springhall Dr, Goose Creek, SC 29445-5335 | 2006-05-11 |
| Street Address |
8761 DORCHESTER RD SUITE 230 |
| City | NORTH CHARLESTON |
| State | SC |
| Zip Code | 29420-7322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518365899 | Melissa Marie Meador | Nurse Practitioner | 8761 Dorchester Rd, Suite 230, North Charleston, SC 29420-7321 | 2014-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467994343 | Sherrel Aiken Brown | Psychologist | 8202 Pleasant Ridge Dr, North Charleston, SC 29420 | 2016-11-09 |
| 1609209014 | Melanie K Wise | Licensed Practical Nurse | 7763 Northside Drive, North Charleston, SC 29420 | 2013-08-21 |
| 1477883767 | Gina H Jones | Counselor | 5421 Riverbluff Pkwy, North Charleston, SC 29420 | 2010-01-08 |
| 1881825933 | Thomas Nelson Pare IIi IIi | Dentist | 8626 Dorchester Road, Ste 102, Coosaw Dental, North Charleston, SC 29420 | 2009-08-06 |
| 1992953012 | Research & Education In Sleep Technologies, LLC | Clinic/Center | 8352 Whitehave Drive, North Charleston, SC 29420 | 2008-09-03 |
| 1194838532 | Raymond S Vicente | Dentist | 7481 Northside Dr, Suite A, North Charleston, SC 29420 | 2006-08-17 |
| 1083628697 | Eunice D Freeman | Counselor | 403 Willow Court, N.charleston, SC 29420 | 2006-07-28 |
| 1750300406 | Alan Boyer Mcdaniel | Specialist | 7510 Northforest Drive, North Charleston, SC 29420 | 2006-07-19 |
| 1548240559 | John Joseph Forney | Family Medicine | 8761 Dorchester Rd Suite 230, Charleston, SC 29420 | 2006-01-18 |
| 1609320217 | Charleston Dermatology, PC | Dermatology | 5401 Netherby Lane, Ste 1202, North Charleston, SC 29420 | 2016-08-11 |
| Find all providers in zip 29420 | ||||
| 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 |
|---|---|---|---|---|
| 1578115911 | Whole Heart Family Medicine | Family Medicine | 2891 Tricom St Ste C, North Charleston, SC 29406-7110 | 2019-07-16 |
| 1821443896 | Liberty Doctors, LLC | Family Medicine | 9275 D Medical Plaza Dr., North Charleston, SC 29406 | 2016-04-27 |
| 1366816977 | Paladina Health, LLC | Family Medicine | 5401 Netherby Rd Ste 101, North Charleston, SC 29420-7363 | 2015-11-19 |
| 1235434713 | Julie All Med Services Inc | Family Medicine | 1455 Remount Rd Ste I, North Charleston, SC 29406-3355 | 2011-01-14 |
| 1760642821 | Laura Lee Smith | Family Medicine | 1670 Dry Dock Ave, Building 10: Harvest Free Medical Clinic, North Charleston, SC 29405-2114 | 2008-06-12 |
| 1306033634 | Katherine Jaudon Richardson | Family Medicine | 4050 Bridge View Dr Ste 600, North Charleston, SC 29405 | 2007-10-01 |
| 1033316641 | Julie Fritz Casasco | Family Medicine | 3337 Business Cir, North Charleston, SC 29418-7415 | 2007-06-27 |
| 1528288560 | Stela Susac-pavic | Family Medicine | 8983 University Blvd # 104-334, North Charleston, SC 29406-7102 | 2007-05-01 |
| 1013087949 | Christopher James Raispis | Family Medicine | 1670 Drydock Ave, Bldg 10a Detyens Medical Center, North Charleston, SC 29405 | 2006-11-08 |
| 1548344096 | Kenneth Phylex Jones | Family Medicine | 3870 Leeds Avenue, Suite 114, North Charleston, SC 29405-7493 | 2006-10-24 |
| Find all providers in NORTH CHARLESTON | ||||
| City | NORTH CHARLESTON |
| Zip Code | 29420 |
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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.