DR. KACEY ERIN O'MALLEY (NPI# 1962851030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962851030 |
| Entity Type | Individual |
| Full Name | DR. KACEY ERIN O'MALLEY |
| Credential | M.D. |
| Practice Address |
2051 Charlie Hall Blvd Charleston SC 29414-5834 |
| Practice Telephone | 8435732535 |
| Practice Fax Number | 8435732534 |
| Mailing Telephone | (323) 361-2122 |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 40312 | SC | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 142190 | CA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1952 Long Grove Dr Ste 202, Mt Pleasant, SC 294647579 | 8439712992 | 8435732535 |
| 776 Daniel Ellis Dr Ste A, Charleston, SC 294123094 | 8437958100 | 8435732534 |
| 9165 University Blvd Ste 100, North Charleston, SC 294067133 | 8432844255 | 8435732534 |
| Street Address |
2051 CHARLIE HALL BLVD |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29414-5834 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225028806 | Kimberly M Devolld | Legal Medicine | 2051 Charlie Hall Blvd, Charleston, SC 29414 | 2005-10-25 |
| 1235792425 | Matthew Robert Horton | Counselor | 2051 Charlie Hall Blvd, Charleston, SC 29414-5834 | 2019-04-15 |
| 1083110019 | Coastal Pediatric Associates, P.a. | Psychologist | 2051 Charlie Hall Blvd, Charleston, SC 29414-5834 | 2018-03-30 |
| 1912389628 | Lauren Clifford Lucas | Pediatrics | 2051 Charlie Hall Blvd, Charleston, SC 29414 | 2015-06-18 |
| 1629459920 | Rodrigo Garcia De La Torre Astudillo | Pediatrics | 2051 Charlie Hall Blvd, Charleston, SC 29414 | 2015-06-11 |
| 1487034880 | Kathleen Mary Ronin | Pediatrics | 2051 Charlie Hall Blvd, Charleston, SC 29414 | 2015-06-02 |
| 1902208010 | Rachel Werth Mcdowell | Nurse Practitioner | 2051 Charlie Hall Blvd, Charleston, SC 29414-5834 | 2014-09-19 |
| 1851791925 | Joan Tufts | Registered Nurse | 2051 Charlie Hall Blvd, Charleston, SC 29414-5834 | 2014-08-26 |
| 1174955660 | Sarah French Conrad | Registered Nurse | 2051 Charlie Hall Blvd, Charleston, SC 29414-5834 | 2013-08-06 |
| 1003258864 | Kristen Slagel Garrett | Nurse Practitioner | 2051 Charlie Hall Blvd, Charleston, SC 29414-5834 | 2013-07-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902444508 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 3865 West Ashley Circle, Charleston, SC 29414 | 2019-12-13 |
| 1215440169 | Christine Michelle Delcioppo | Nurse Practitioner | 2085 Henry Tecklenburg Dr Fl 2or2, Charleston, SC 29414 | 2017-11-14 |
| 1871013508 | Carolyn Sorenson | Assistant Behavior Analyst | 2218 Hunter Creek Dr, Charleston, SC 29414 | 2017-06-23 |
| 1205387354 | Rachel Klatt | Physical Therapist | 2230 Ashley Crossing Dr., Charleston, SC 29414 | 2016-10-24 |
| 1295286912 | Mary M Butler | Physical Therapy Assistant | 2230 Ashley Crossing Drive, Charleston, SC 29414 | 2016-10-18 |
| 1295104982 | Charlene Barbot | Registered Nurse | 3741 Clover St, Charleston, SC 29414 | 2015-09-23 |
| 1720467525 | Sasha M. Perez | Family Medicine | 3030 Ashley Town Center Dr Ste 102a, Charleston, SC 29414 | 2015-05-26 |
| 1104226240 | Angela Mcinvale | Counselor | 3030 Ashley Town Center Dr., Bldg. B-203, Charleston, SC 29414 | 2014-08-26 |
| 1659790087 | Catherine Jefferson Vanderwerker | Physical Therapist | 3019 Saintsbury Cove Dr, Charleston, SC 29414 | 2014-04-14 |
| 1104266741 | Elizabeth A Burguieres | Psychiatry & Neurology | Scdmh- Charleston Telepsychiatry Office, 706 Orleans Rd, Charleston, SC 29414 | 2013-06-27 |
| Find all providers in zip 29414 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023632809 | Caitlin Marie Stoll | Pediatrics | 2244 Ashley Crossing Dr Unit 536, Charleston, SC 29414-6168 | 2020-06-08 |
| 1134743420 | Elizabeth Alden Mccants | Pediatrics | 125 Doughty St Ste 520d, Charleston, SC 29403-5736 | 2020-06-02 |
| 1770127516 | Nicole Danielle Clendenin | Pediatrics | 314 Goff Mountain Rd Ste 16, Charleston, WV 25313-6600 | 2019-11-05 |
| 1871059238 | Aminah Fraser- Abdur Rahim | Pediatrics | 1373 W Lenevar Dr, Charleston, SC 29407-5148 | 2019-02-11 |
| 1720518384 | Nicholas Matthew Cundiff | Pediatrics | 135 Rutledge Ave Dept Of, Charleston, SC 29425-8903 | 2017-06-15 |
| 1649632225 | Collin Dubick | Pediatrics | 1118 Sea Eagle Watch, Charleston, SC 29412-8249 | 2016-03-23 |
| 1417338781 | Heather Michelle Greene | Pediatrics | 169 Ashlet Avenue, Room 202 Main Hospital Msc 333, Charleston, SC 29425 | 2015-06-12 |
| 1780098160 | Matthew John Saia | Pediatrics | 2124 Telfair Way, Charleston, SC 29412-2370 | 2014-06-13 |
| 1770922601 | Lauren Simpson Tipton | Pediatrics | 1243 Savannah Hwy Ste B, Charleston, SC 29407-7817 | 2013-06-25 |
| 1467747527 | Pratikkumar Patel | Pediatrics | 830 Pennsylvania Ave Ste 401, Charleston, WV 25302-3390 | 2011-06-16 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 29414 |
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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.