Active NPI
Tanya Am Nanongkhai
- Pediatrics Physician
- Charleston, SC
National Provider Identifier
1033748967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 90003
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Health Centers, Inc | Current | Accepting new patients | |
| Family Health Centers, Inc | Current | 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
- tnanongkhai617616@direct.peacehealth.org
- https://fhir4.healow.com/fhir/r4/BFEFCD
- 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.
-
- Federally Qualified Health Center (FQHC)
- Orangeburg, SC
- NPI 1144248451
-
- Federally Qualified Health Center (FQHC)
- Holly Hill, SC
- NPI 1609279744
-
- Federally Qualified Health Center (FQHC)
- Saint George, SC
- NPI 1437353794
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.