Individual provider Active NPI

Tanya Am Nanongkhai

  • Pediatrics Physician
  • Charleston, SC
National Provider Identifier
1033748967
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
90003 Issued in SC
Practice address
1061 King St
Charleston, SC 29403-3708
Phone
(843) 985-4473
NPI assigned
Apr 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 90003 SC Primary
Pediatrics Physician 208000000X MD61446233 WA

Addresses

Primary practice location

1061 King St
Charleston, SC 29403-3708

Mailing address

125 Doughty St Ste 530
MSC 917
Charleston, SC 29403-5744
Phone (843) 792-0269

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240104000424 SC Practitioner - Pediatric Medicine 2264895911 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers, Inc CurrentSince Sep 1, 2023 Accepting new patients
Family Health Centers, Inc CurrentSince Sep 1, 2023 Accepting new patients
Family Health Centers, Inc. Past Accepting new patients

Locations

922 Holly St
Holly Hill, SC 29059
Phone (803) 496-7174

3310 Magnolia St
Orangeburg, SC 29115
Phone (803) 531-6900

401 Ridge St
Saint George, SC 29477
Phone (843) 563-5315

Interoperability endpoints

  • Direct secure messaging: tnanongkhai617616@direct.peacehealth.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/BFEFCD
  • FHIR API: https://fhir4.healow.com/fhir/r4/AJHIBD/Endpoint/AJHIBD

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1033748967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 DOUGHTY ST STE 530",
            "address_2": "MSC 917",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294035744",
            "telephone_number": "843-792-0269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 KING ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294033708",
            "telephone_number": "843-985-4473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANONGKHAI",
        "first_name": "TANYA",
        "middle_name": "AM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-02",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "90003",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD61446233",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.