LIBERTY DOCTORS LLC (NPI# 1760083562) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760083562 |
| Entity Type | Organization |
| Organization Name | LIBERTY DOCTORS LLC |
| Practice Address |
9133 Timber St North Charleston SC 29406-9075 |
| Practice Telephone | 8437796444 |
| Practice Fax Number | 8437796438 |
| Mailing Telephone | 8437796444 |
| Mailing Fax Number | 8437796438 |
| Enumeration Date | 2020-11-06 |
| Last Update Date | 2020-11-06 |
| Authorized Official Name | MRS. SARA ELIZABETH MAYNOR-HARDY (CREDENTIALING MANAGER) |
| Authorized Official Telephone | 8432258320 |
| Is Organization Subpart | Y |
| Parent Organization Name | LIBERTY DOCTORS, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | MEDICARE PART B | A634 | 01 |
| SC | GP6738 | 05 |
| Other Name | Type Code |
|---|---|
| Viduya Family Practice | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700162203 | Liberty Doctors LLC | Clinical Nurse Specialist | 8761 Dorchester Rd Ste 230, Charleston, SC 29420-7322 | 2011-10-27 |
| 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 |
9133 TIMBER ST |
| City | NORTH CHARLESTON |
| State | SC |
| Zip Code | 29406-9075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104842442 | Lina Leigh Wood | Advanced Practice Midwife | 9133 Timber St, North Charleston, SC 29406-9075 | 2006-07-13 |
| 1598168486 | Erin Stein | Advanced Practice Midwife | 9133 Timber St, North Charleston, SC 29406-9075 | 2014-10-06 |
| 1184978025 | Jennifer Hirchert | Advanced Practice Midwife | 9133 Timber St, North Charleston, SC 29406-9075 | 2012-10-30 |
| 1922336536 | Sarah C Brunson | Registered Nurse | 9133 Timber St, North Charleston, SC 29406-9075 | 2009-11-20 |
| 1619162500 | Charleston Birth Place, Inc | Clinic/Center | 9133 Timber St, Suite 101, North Charleston, SC 29406 | 2007-09-13 |
| 1134239023 | Laurie D Hersey | Advanced Practice Midwife | 9133 Timber St, Suite 101, North Charleston, SC 29406-9075 | 2006-08-30 |
| 1093823049 | Amy E Mccurley | Advanced Practice Midwife | 9133 Timber St, North Charleston, SC 29406-9075 | 2006-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023622289 | Sara Desmarais | Physical Therapist | 2760 Tricom St, North Charleston, SC 29406 | 2020-09-04 |
| 1669036448 | Pink Elephant Autism Project | In Home Supportive Care | 8738 Red Oak Drive, Charleston, SC 29406 | 2019-04-26 |
| 1083171185 | Medical University Hospital Authority | Pharmacy | 2250 Mall Drive, North Charleston, SC 29406 | 2019-02-25 |
| 1336627371 | Truesdale Medical Center LLC | Internal Medicine | 6296 Rivers Ave., Suite 310, N. Charleston, SC 29406 | 2018-08-01 |
| 1164914552 | Amanda R Dipiazza | Nurse Anesthetist, Certified Registered | 9330 Medical Plaza Dr Ste E, Charleston, SC 29406 | 2018-06-01 |
| 1982148490 | Trident Medical Center | Psychiatric Hospital | 9225 C Medical Plaza Drive, Charleston, SC 29406 | 2016-12-19 |
| 1649726217 | First Choice Counseling Services, LLC | Community/Behavioral Health | 2245 Greenridge Rd., Unit#414, North Charleston, SC 29406 | 2016-09-01 |
| 1821443896 | Liberty Doctors, LLC | Family Medicine | 9275 D Medical Plaza Dr., North Charleston, SC 29406 | 2016-04-27 |
| 1174984645 | Ashia George | Developmental Therapist | 6650 Rivers Avenue, Ste 100, Charleston, SC 29406 | 2016-03-11 |
| 1023488582 | Etta Smith | Counselor | 2470 Mall Dr Unit Cd, North Charleston, SC 29406 | 2015-09-28 |
| Find all providers in zip 29406 | ||||
| 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 | 29406 |
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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.