NPIMap

Organization Active NPI

Liberty Doctors, LLC

  • Internal Medicine Physician
  • Charleston, SC
National Provider Identifier
1194380162
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LIBERTY DOCTORS, LLC
Doing business as
Laura Lee Kinney MD
Practice address
2270 Ashley Crossing Dr Ste 165
Charleston, SC 29414-5865
Phone
(843) 936-4455
Fax
(843) 268-2670
NPI assigned
May 6, 2019
Organization subpart
Yes
Parent organization
LIBERTY DOCTORS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Authorized official

Name
Chelsey Dever
Title
Credentialing Coordinator
Phone
(843) 225-8320

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2270 Ashley Crossing Dr Ste 165
Charleston, SC 29414-5865

Mailing address

PO Box 13955
Charleston, SC 29422-3955
Phone (843) 225-8320

Other identifiers 3

IdentifierTypeStateIssuer
GP6738MedicaidSC
194667MedicaidSC
A634OtherSCMEDICARE PTAN

Other names 1

  • Laura Lee Kinney MD Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2167887Liberty Doctors LLC Kinney2270 Ashley Crossing Drive, Ste 165, Charleston, SC 29414Certificate of waiverJun 17, 2027

National Provider Directory

National Provider Directory
Tax ID family
Liberty Doctors LLC Dba Ebb Tide Comprehensive Care12 organizations share this tax ID, including this one
Part of
Liberty Doctors LLC Dba Ebb Tide Comprehensive Care

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765756800000",
    "number": "1194380162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13955",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294223955",
            "telephone_number": "843-225-8320",
            "fax_number": "843-225-3549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2270 ASHLEY CROSSING DR STE 165",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145865",
            "telephone_number": "843-936-4455",
            "fax_number": "843-268-2670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY DOCTORS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIBERTY DOCTORS, LLC",
        "enumeration_date": "2019-05-06",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A",
        "authorized_official_last_name": "DEVER",
        "authorized_official_first_name": "CHELSEY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "843-225-8320"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP6738",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194667",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "A634",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laura Lee Kinney MD",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Laura Lee Kinney MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 15, 2025; 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.