MAGNOLIA FUNCTIONAL MEDICINE LLC NPI 1952196826

NPI Information

  • NPI: 1952196826
  • Provider Name: MAGNOLIA FUNCTIONAL MEDICINE, LLC
  • Classification: General Practice - 208D00000X
  • Entity Type: Organization
  • Address: 1064 GARDNER RD STE 208
    CHARLESTON, SC
    ZIP 29407
  • Phone: (843) 501-2333

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NPI Details

MAGNOLIA FUNCTIONAL MEDICINE, LLC is a general practice in Charleston, SC. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee MAGNOLIA FUNCTIONAL MEDICINE, LLC NPI is 1952196826. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1064 GARDNER RD STE 208
CHARLESTON, SC
ZIP 29407-712
Phone: (843) 501-2333

The provider's authorized official is Sarah Ellis .
The authorized official title is Partial-owner and has the following contact phone number (843) 501-2333.

The enumeration date for this NPI number is 4/11/2025 and was last updated on 4/11/2025.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1175F00000XNaturopathNo
2207RE0101XInternal MedicineEndocrinology, Diabetes & MetabolismNo
3208D00000XGeneral PracticeYes

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: 11/21/2025

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