Organization Active NPI

Well Family Medicine

  • Family Medicine Physician
  • Charleston, SC
National Provider Identifier
1326074576
Registry record updated Jul 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19704 Issued in SC
Legal business name
WELL FAMILY MEDICINE
Practice address
1483 Tobias Gadson Blvd
Suite 102
Charleston, SC 29407-8702
Phone
(843) 766-6229
Fax
(843) 766-2315
NPI assigned
Jun 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2008

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

Authorized official

Name
Ms. Lori Ann Cox
Title
Practice Manager
Phone
(843) 766-6229

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Legal MedicineGroup: 193200000X MULTI-SPECIALTY GROUP 173000000X 19704 SC
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 19704 SC Primary

Addresses

Primary practice location

1483 Tobias Gadson Blvd
Suite 102
Charleston, SC 29407-8702

Mailing address

1483 Tobias Gadson Blvd
Suite 102
Charleston, SC 29407-8702
Phone (843) 766-6229

Other identifiers 1

IdentifierTypeStateIssuer
197049MedicaidSC

National Provider Directory

National Provider Directory

Locations

1483 Tobias Gadson Blvd
Ste 102
Charleston, SC 29407
Phone (843) 766-6229

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215388800000",
    "number": "1326074576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1483 TOBIAS GADSON BLVD",
            "address_2": "SUITE 102",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294078702",
            "telephone_number": "843-766-6229",
            "fax_number": "843-766-2315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1483 TOBIAS GADSON BLVD",
            "address_2": "SUITE 102",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294078702",
            "telephone_number": "843-766-6229",
            "fax_number": "843-766-2315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELL FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2008-07-07",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "843-766-6229",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Legal Medicine",
            "state": "SC",
            "license": "19704",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "19704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197049",
            "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 Jul 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.