Angel Oak Pediatrics LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

ANGEL OAK PEDIATRICS LLC

Practice address

3312 Maybank Hwy Ste B
Johns Island, SC 29455-4818

Phone

(843) 894-3490

Fax

(833) 450-6022

NPI assigned

Nov 20, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Kelli E Johnston, DONPI 1689797268

Title

Pediatrician/Owner

Phone

(248) 760-4587

Specialties & licenses 2

Addresses

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

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelli Elizabeth Johnston, D.O.

  • Pediatrics Physician
  • Johns Island, SC
  • NPI 1689797268
  NPD Authorized official
• Cori Lyn Rogers, MSN, RN, CPNP

  • Pediatric Nurse Practitioner
  • Johns Island, SC
  • NPI 1982707501
  NPD (past)

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

{
    "created_epoch": "1700438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779926400000",
    "number": "1265207229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 WATERLEAF RD",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "294553176",
            "telephone_number": "248-760-4587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3312 MAYBANK HWY STE B",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "294554818",
            "telephone_number": "843-894-3490",
            "fax_number": "833-450-6022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL OAK PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-20",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "KELLI",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PEDIATRICIAN/OWNER",
        "authorized_official_telephone_number": "248-760-4587",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alpha Home Care LLC
• Natalie Altieri, MA, LPC
• Rebekah Gould Anderson, DMD
• Angel Oak Eye Center
• Angel Oak Family Medicine LLC
• Anthony C Ross
• Bradley Paul Anuszkiewicz
• Kimberly A Arza, RN
• Sharon Ashley, MSPT
• Thomas Adam Auten, PT, DPT

• Pediatrics Physician in Johns Island, SC
• Providers in Johns Island, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; 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.