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LIBERTY DOCTORS LLC D/B/A FAMILY FIRST MEDICAL CARE NPI 1417967092


NPI Information

NPI: 1417967092
Provider Name: LIBERTY DOCTORS LLC D/B/A FAMILY FIRST MEDICAL CARE

Former Legal Business Name: HEALTH CARE CONSULTANTS OF CHARLESTON

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 42D2167887

Address:
2270 ASHLEY CROSSING DR STE 150
CHARLESTON, SC
ZIP 29414
Phone: (843) 766-1936
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LIBERTY DOCTORS LLC D/B/A FAMILY FIRST MEDICAL CARE is a family medicine in Charleston, SC. The provider is 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. LIBERTY DOCTORS LLC D/B/A FAMILY FIRST MEDICAL CARE NPI is 1417967092. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Health Care Consultants Of Charleston.

The provider's business location address is:

2270 ASHLEY CROSSING DR STE 150
CHARLESTON, SC
ZIP 29414-702
Phone: (843) 766-1936
Fax: (843) 766-1206

The provider's authorized official is Elizabeth Maynor-hardy .
The authorized official title is Credentialing Coordinator and has the following contact phone number (843) 225-8320.

The CLIA number assigned to this NPI record is 42D2167887 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/8/2006 and was last updated on 9/21/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine22266SOUTH CAROLINAYes
2207Q00000XFamily Medicine6385SOUTH CAROLINANo
3207Q00000XFamily Medicine21948SOUTH CAROLINANo
4207Q00000XFamily Medicine24446SOUTH CAROLINANo
5207R00000XInternal Medicine5942SOUTH CAROLINANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1280508389OTHERSOUTH CAROLINABCBS
2F51580MEDICARE UPINSOUTH CAROLINA
3G21879MEDICARE UPINSOUTH CAROLINA
4E38172MEDICARE UPINSOUTH CAROLINA
5247253076OTHERSOUTH CAROLINABCBS
6B1015OTHERSOUTH CAROLINAMEDCOST
7400560049OTHERSOUTH CAROLINABCBS
87036MEDICARE PINSOUTH CAROLINA
9G33574MEDICARE UPINSOUTH CAROLINA
10194667MEDICAIDSOUTH CAROLINA
11GP3158MEDICAIDSOUTH CAROLINA
12247743969OTHERSOUTH CAROLINABCBS
13257064675OTHERSOUTH CAROLINABCBS
14H59795MEDICARE UPINSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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