Health Edge Laser LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25789 Issued in SC

Legal business name

HEALTH EDGE LASER LLC

Practice address

4965 Centre Pointe Dr. Suite 100
North Charleston, SC 29418

Phone

(843) 569-2225

Fax

(843) 863-1830

NPI assigned

Jun 13, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Carolyn Leigh Hunter, DC

Title

Owner

Phone

(843) 870-8703

Specialties & licenses 9

Addresses

Other identifiers 2

Other names 1

• Health Edge Medical and Wellness Center Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488931200000",
    "number": "1003265828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4965 CENTRE POINTE DR. SUITE 100",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "29418",
            "telephone_number": "843-569-2225",
            "fax_number": "843-863-1830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4965 CENTRE POINTE DR. SUITE 100",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "29418",
            "telephone_number": "843-569-2225",
            "fax_number": "843-863-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH EDGE LASER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-13",
        "last_updated": "2017-03-08",
        "status": "A",
        "authorized_official_last_name": "HUNTER",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-870-8703",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2991",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "25789",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "5337",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "18243",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "3749",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP6680",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN MEDICARE",
            "identifier": "D992",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Health Edge Medical and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.