LIBERTY DOCTORS LLC (NPI# 1700162203) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700162203 |
| Entity Type | Organization |
| Organization Name | LIBERTY DOCTORS LLC |
| Other Organization Name | MOBILE MEDICAL CONSULTANTS |
| Practice Address |
8761 Dorchester Rd Ste 230 Charleston SC 29420-7322 |
| Mailing Address |
8761 Dorchester Rd Suite 230 Charleston SC 29420-7321 |
| Practice Telephone | 8434712273 |
| Practice Fax Number | 8433778180 |
| Mailing Telephone | 8434121590 |
| Mailing Fax Number | 8432253549 |
| Enumeration Date | 2011-10-27 |
| Last Update Date | 2019-07-22 |
| Authorized Official Name | MRS. LISSA C LARA (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 8434121590 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 364SF0001X |
Clinical Nurse Specialist Specialization: Family Health |
1804 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
30704 | SC | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | SC | Allopathic & Osteopathic Physicians | |
| N | 364SF0001X |
Clinical Nurse Specialist Specialization: Family Health |
3438 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 207Q00000X | Family Medicine | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | G50785 | 05 | |
| SC | MEDICARE PTAN | SC6924A634 | 01 |
| SC | GP6738 | 05 |
| Other Name | Type Code |
|---|---|
| Mobile Medical Consultants | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760083562 | Liberty Doctors LLC | Family Medicine | 9133 Timber St, North Charleston, SC 29406-9075 | 2020-11-06 |
| 1558928614 | Liberty Doctors LLC | Pediatrics | 3800 Faber Place Dr, Charleston, SC 29405-8532 | 2019-05-23 |
| 1659831246 | Liberty Doctors LLC | Family Medicine | 1064 Gardner Rd Ste 105-106, Charleston, SC 29407-5768 | 2019-03-21 |
| 1013477827 | Liberty Doctors LLC | Internal Medicine | 2270 Ashley Crossing Dr Ste 155, Charleston, SC 29414-5749 | 2019-03-20 |
| 1184169799 | Liberty Doctors LLC | Family Medicine | 110a Springhall Dr, Goose Creek, SC 29445-5335 | 2017-01-05 |
| 1164964904 | Liberty Doctors LLC | Family Medicine | 1477 Tobias Gadson Blvd, Charleston, SC 29407-4794 | 2016-11-10 |
| 1063954956 | Liberty Doctors LLC | Family Medicine | 110a Springhall Dr, Goose Creek, SC 29445-5335 | 2016-11-09 |
| Street Address |
8761 DORCHESTER RD STE 230 |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29420-7322 |
| 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 |
|---|---|---|---|---|
| 1811595499 | Laura Coolidge | Family Medicine | 1528 Seacroft Rd, Charleston, SC 29412-8113 | 2020-10-15 |
| 1356954259 | Relymd Medical Group Wv, Pllc | Family Medicine | 1627 Quarrier St, Charleston, WV 25311-2124 | 2020-08-28 |
| 1922617950 | Fred E Hill | Family Medicine | 1033 Jervey Point Rd, Charleston, SC 29492-8372 | 2020-07-27 |
| 1093375222 | Valley Health Systems, Inc. | Family Medicine | 333 Laidley St Fl 6, Charleston, WV 25301-1614 | 2019-06-19 |
| 1427512201 | Catherine Courtney Slemp | Family Medicine | 350 Capitol St Rm 702, Charleston, WV 25301-1757 | 2019-01-25 |
| 1730677709 | Courtney Uhlar | Family Medicine | 169 Ashley Ave # Msc333, Charleston, SC 29425-9125 | 2018-04-25 |
| 1134617335 | Kelsey Rose Wilson | Family Medicine | 169 Ashley Ave. Room 202, Main Hospital Msc 333, Charleston, SC 29425-9125 | 2018-04-24 |
| 1659869816 | Anthony James Baglio | Family Medicine | 169 Ashley Avenue, Room 202 Main Hospital, Msc 333, Charleston, SC 29425 | 2018-04-24 |
| 1396252219 | Lisa Ann Oshaughnessy Turnure | Family Medicine | 3 Sawgrass Rd Apt I6, Charleston, SC 29412-2579 | 2017-12-30 |
| 1720467525 | Sasha M. Perez | Family Medicine | 3030 Ashley Town Center Dr Ste 102a, Charleston, SC 29414 | 2015-05-26 |
| Find all providers in CHARLESTON | ||||
| City | 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.