NPIMap

Individual provider Active NPI

Justin William Dean, M.D.

  • Family Medicine Physician
  • Charleston, SC
National Provider Identifier
1013355114
Registry record updated Oct 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
LL35779 Issued in SC
Practice address
2125 Charlie Hall BVLD
Ste 2
Charleston, SC 29414
Phone
(843) 876-3151
NPI assigned
Jun 11, 2013
Last updated
Oct 21, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X LL35779 SC Primary

Addresses

Primary practice location

2125 Charlie Hall BVLD
Ste 2
Charleston, SC 29414

Mailing address

PO Box 602108
Charlotte, NC 28260-2108
Phone (843) 792-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161209002089 SC Practitioner - Family Practice 7911221247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in Shreveport, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolina Family Care IncGroup PAC ID 4587557731, 81 clinicians

Practice addresses (Care Compare)

490 Martello Dr
Charleston, SC 29412-2638
Phone (843) 762-5480

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.96 of 100Reported as group
Quality
89.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
LL35779SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Family Care, Inc Family Medicine CurrentSince Mar 1, 2020 Accepting new patients
Carolina Family Care Inc CurrentSince Mar 1, 2020 Accepting new patients
Carolina Family Care, Inc Past Accepting new patients
Carolina Family Care, Inc Past Accepting new patients

Locations

2075 Charlie Hall Blvd
#B
Charleston, SC 29414
Phone (843) 876-3157

2125 Charlie Hall Blvd
Ste 2
Charleston, SC 29414
Phone (843) 876-3151

2125 Charlie Hall Blvd
Ste 2B
Charleston, SC 29414
Phone (843) 852-3151

490 Martello Dr
Charleston, SC 29412
Phone (843) 762-4963

1113 Park West Blvd
Mt Pleasant, SC 29466
Phone (843) 876-1445

1208 Two Island Ct
Mt Pleasant, SC 29466
Phone (843) 884-6653

Interoperability endpoints

  • Direct secure messaging: jdean25514@direct.musc.edu

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477008000000",
    "number": "1013355114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602108",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602108",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 CHARLIE HALL BVLD",
            "address_2": "STE 2",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29414",
            "telephone_number": "843-876-3151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "JUSTIN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-11",
        "last_updated": "2016-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL35779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.