Charleston Brace Company, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

015090713 Issued in SC

Legal business name

CHARLESTON BRACE COMPANY, LLC

Practice address

111 Magnolia St
Walterboro, SC 29488-2911

Phone

(843) 542-9000

Fax

(843) 542-2612

NPI assigned

Jun 15, 2007

Last updated

Jul 15, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

CHARLESTON BRACE COMPANY, LLCAs reported in NPPES

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

Authorized official

Name

Mr. Nathaniel Jackson, CO, CPED

Title

Owner

Phone

(843) 542-9000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Charleston Brace Company, LLC

  • Prosthetic/Orthotic Supplier
  • Ladson, SC
  • NPI 1720171929

  3274744735

  Same PAC ID

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

Medicare medical equipment & supply locations

Part of

Charleston Brace Company LLC

Locations

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1063617629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9470 HIGHWAY 78 # A",
            "city": "LADSON",
            "state": "SC",
            "postal_code": "294563909",
            "telephone_number": "843-871-0600",
            "fax_number": "843-871-6510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MAGNOLIA ST",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294882911",
            "telephone_number": "843-542-9000",
            "fax_number": "843-542-2612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESTON BRACE COMPANY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHARLESTON BRACE COMPANY, LLC",
        "enumeration_date": "2007-06-15",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "NATHANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-542-9000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CO, CPED"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "SC",
            "license": "015090713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Michelle Gruber Carter, APRN
• Carya Emergency Physicians, LLC
• Shaleka Lasha Castro
• Jennifer L Causey, C.R.N.A.
• Ashley Kate Cauthen, DMD
• Charleston Cancer Center
• Charleston Family Center, LLC in Walterboro
• Linda Chipukites, M.S.
• Coastal Ambulance LLC (Coastal Ambulance)
• Coastal Kids Dental & Braces

• Prosthetic/Orthotic Supplier in Walterboro, SC
• Providers in Walterboro, SC by specialty
• Prosthetic/Orthotic Supplier in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.