Individual provider Active NPI

William R. Andrews, APRN

  • Gerontology Nurse Practitioner
  • Charleston, SC
National Provider Identifier
1154969012
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
23117 Issued in SC
Practice address
125 Wappoo Creek Dr Ste 202a
Charleston, SC 29412-5100
Phone
(843) 913-8558
Fax
(843) 284-9558
NPI assigned
Dec 11, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 23117 SC Primary

Addresses

Primary practice location

125 Wappoo Creek Dr Ste 202a
Charleston, SC 29412-5100

Mailing address

PO Box 13689
Charleston, SC 29422-3689
Phone (843) 913-8558

Other identifiers 1

IdentifierTypeStateIssuer
NP6489MedicaidSC

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200130001361 SC Practitioner - Nurse Practitioner 5395171938 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charleston Medicine and Behavioral Health, LLCGroup PAC ID 0749658680, 2 clinicians

Practice addresses (Care Compare)

125 Wappoo Creek Dr
Suite 202a
Charleston, SC 29412-5100
Phone (843) 913-8858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Andrews Healthcare, LLC CurrentSince Aug 2, 2022 Accepting new patients
Charleston Medicine and Behavioral Health, LLC CurrentSince Oct 27, 2021 Accepting new patients
Palmetto Primary Care Physicians, LLC CurrentSince Jan 2, 2020 Accepting new patients
Palmetto Primary Care Physicians, LLC CurrentSince Jan 2, 2020 Accepting new patients
Palmetto Primary Care Physicians, LLC Current Accepting new patients

Locations

125 Wappoo Creek Dr
Charleston, SC 29412
Phone (843) 762-6311

125 Wappoo Creek Dr
Ste 202A
Charleston, SC 29412
Phone (843) 913-8558

201 Sigma Dr
Ste 100
Summerville, SC 29486
Phone (843) 820-3397

201 Oakbrook Ln
Ste 255
Summerville, SC 29485
Phone (843) 695-8464

1516 Old Trolley Rd
Ste 101
Summerville, SC 29485
Phone (843) 203-9393

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25788/brand/1/csg/1/fhir/r4
  • Direct secure messaging: william.andrews.1@25788.direct.athenahealth.com

Organizations & group practices 5

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": "1576022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1154969012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13689",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294223689",
            "telephone_number": "843-913-8558",
            "fax_number": "843-284-9558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 WAPPOO CREEK DR STE 202A",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294125100",
            "telephone_number": "843-913-8558",
            "fax_number": "843-284-9558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREWS",
        "first_name": "WILLIAM",
        "middle_name": "R.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-11",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "SC",
            "license": "23117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP6489",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.