NPIMap

Individual provider Active NPI

Robert John Teachman, D.O.

  • Family Medicine Physician
  • Charleston, SC
National Provider Identifier
1205926920
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
930 Issued in SC
Practice address
776 Daniel Ellis Dr
Suite 1-B
Charleston, SC 29412-3094
Phone
(843) 795-0300
Fax
(843) 795-1952
NPI assigned
Oct 13, 2006
Last updated
Jun 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 930 SC Primary

Addresses

Primary practice location

776 Daniel Ellis Dr
Suite 1-B
Charleston, SC 29412-3094

Mailing address

PO Box 530062
Atlanta, GA 30353-0062
Phone (843) 695-6071

Other identifiers 2

IdentifierTypeStateIssuer
P01157479OtherSCRR-MEDICARE
009305MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090218000399 SC Practitioner - Family Practice 6800951260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Arizona College of Osteopathic Medicine Mid Western University, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

776 Daniel Ellis Dr
Suite 1B
Charleston, SC 29412-3095
Phone (843) 695-6071

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
930SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Primary Care Physicians, LLC Family Medicine Current Accepting new patients
Palmetto Primary Care Physicians, LLC Family Medicine CurrentSince Jan 1, 2013 Accepting new patients
Palmetto Primary Care Physicians, LLC Family Medicine CurrentSince Jan 1, 2013 Accepting new patients
Trident Medical Center, LLC Past Accepting new patients
Palmetto Primary Care Physicians, LLC Family Medicine Past Accepting new patients
Coastal Carolina Primary Care, LLC Past Accepting new patients

Locations

1401 Main St
Bonneau, SC 29431
Phone (843) 825-3404

776 Daniel Ellis Dr
Ste 1B
Charleston, SC 29412
Phone (843) 795-0300

2500 Elms Center Rd
North Charleston, SC 29406
Phone (763) 348-2075

2550 Elms Center Rd
North Charleston, SC 29406
Phone (843) 302-8840

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

Interoperability endpoints

  • Direct secure messaging: robert.teachman@ppcp1.eclinicaldirectplus.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1205926920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530062",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303530062",
            "telephone_number": "843-695-6071",
            "fax_number": "843-569-5879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "776 DANIEL ELLIS DR",
            "address_2": "SUITE 1-B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294123094",
            "telephone_number": "843-795-0300",
            "fax_number": "843-795-1952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEACHMAN",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR-MEDICARE",
            "identifier": "P01157479",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009305",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.