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CHARLESTON PEDIATRIC REHABILITATION LLC NPI 1932276805


NPI Information

NPI: 1932276805
Provider Name: CHARLESTON PEDIATRIC REHABILITATION LLC
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
1407 ASHLEY RIVER RD
CHARLESTON, SC
ZIP 29407
Phone: (843) 769-0663
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CHARLESTON PEDIATRIC REHABILITATION LLC is a pediatrics in Charleston, SC. The provider is 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. CHARLESTON PEDIATRIC REHABILITATION LLC NPI is 1932276805. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1407 ASHLEY RIVER RD
CHARLESTON, SC
ZIP 29407-305
Phone: (843) 769-0663
Fax: (843) 769-0556

The provider's authorized official is Michael Coyle .
The authorized official title is Owner and has the following contact phone number (843) 769-0663.

The enumeration date for this NPI number is 11/29/2006 and was last updated on 8/22/2020.


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
1208000000XPediatricsYes
2225100000XPhysical TherapistX
3225X00000XOccupational TherapistX
4235Z00000XSpeech-Language PathologistX

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
1GP3373MEDICAIDSOUTH 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: 11/14/2023

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