NPIMap

Organization Active NPI

Lowcountry Infectious Diseases PA

  • Infectious Disease Physician
  • Charleston, SC
National Provider Identifier
1194778548
Registry record updated May 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
LOWCOUNTRY INFECTIOUS DISEASES PA
Practice address
1938 Charlie Hall Blvd Unit B
Charleston, SC 29414-6099
Phone
(843) 402-0227
Fax
(840) 402-0232
NPI assigned
May 18, 2006
Last updated
May 22, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2015

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

Authorized official

Name
Shannon R McCoin
Title
Ceo
Phone
(843) 212-8669

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X Primary

Addresses

Primary practice location

1938 Charlie Hall Blvd Unit B
Charleston, SC 29414-6099

Mailing address

1938 Charlie Hall Blvd Unit B
Charleston, SC 29414-6099
Phone (843) 402-0227

Other identifiers 1

IdentifierTypeStateIssuer
GP1016MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060620000209 SC Part B Supplier - Clinic/Group Practice 8527070291 Receives reassigned benefits from 17 practitioners
Practice locations: Summerville, SC; Mt Pleasant, SC; Charleston, SC; Beaufort, SC

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
42D2198394Lowcountry Infectious Diseases, PA1938 Charlie Hall Boulevard, Charleston, SC 29414Certificate of waiverNov 1, 2026

National Provider Directory

National Provider Directory

Locations

1938 Charlie Hall Blvd
Unit B
Charleston, SC 29414
Phone (803) 402-0227

1520 Old Trolley Rd
Summerville, SC 29485

1520 Old Trolley Rd
Ste 101
Summerville, SC 29485
Phone (843) 402-0227

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432252800000",
    "number": "1194778548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1938 CHARLIE HALL BLVD UNIT B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294146099",
            "telephone_number": "843-402-0227",
            "fax_number": "840-402-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1938 CHARLIE HALL BLVD UNIT B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294146099",
            "telephone_number": "843-402-0227",
            "fax_number": "840-402-0232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOWCOUNTRY INFECTIOUS DISEASES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2015-05-22",
        "status": "A",
        "authorized_official_last_name": "MCCOIN",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-212-8669"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP1016",
            "state": "SC"
        }
    ],
    "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 May 22, 2015; 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.