Carolina Health and Wellness Services, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

CAROLINA HEALTH AND WELLNESS SERVICES, LLC

Practice address

2754 Maybank Hwy Ste B
Johns Island, SC 29455-4809

Phone

(843) 996-4908

Fax

(843) 962-5450

NPI assigned

Feb 26, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Blake Douglas Devolld, ED.D.

Title

Practice Manager

Phone

(843) 996-4908

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly M Devolld, M.D.

  • General Practice Physician
  • Johns Island, SC
  • NPI 1225028806

  Pediatrics

  NPD

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

{
    "created_epoch": "1614297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614297600000",
    "number": "1043804388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2754 MAYBANK HWY STE B",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "294554809",
            "telephone_number": "843-996-4908",
            "fax_number": "843-962-5450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2754 MAYBANK HWY STE B",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "294554809",
            "telephone_number": "843-996-4908",
            "fax_number": "843-962-5450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA HEALTH AND WELLNESS SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-26",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A",
        "authorized_official_last_name": "DEVOLLD",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "843-996-4908",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "406340",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Calderon
• Callison Dental LLC
• Cynthia Ann Camacho, PHARM D
• Elise Canupp Bynum
• Carolina Family Care, Inc
• Carolina Oaks Behavioral Care
• Sara Tavares Carter, PHARMD
• Taylor Adam Carter, MD
• Marsha Schroeder Cayton, NP
• Lisa Ceinski, MS, OTR/L

• Pediatrics Physician in Johns Island, SC
• Providers in Johns Island, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.