Individual provider Active NPI

Joanne M Keefe-Tomasello, NP

  • Nurse Practitioner
  • Summerville, SC
National Provider Identifier
1366471252
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1259 Issued in SC
Practice address
410 N Main St
Summerville, SC 29483-6420
Phone
(843) 871-3277
Fax
(843) 871-3360
NPI assigned
Jul 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1259 SC Primary

Addresses

Primary practice location

410 N Main St
Summerville, SC 29483-6420

Mailing address

PO Box 749306
Atlanta, GA 30374-9306

Other practice location 1

1851 Sam Rittenberg Blvd
Charleston, SC 29407-4861
Phone (843) 556-5585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100622000639 SC Practitioner - Nurse Practitioner 6002947983 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Urgent Cares LLC CurrentSince Nov 1, 2024 Accepting new patients

Locations

6167 Braided Mane Pass SW
Aiken, SC 29803
Phone (803) 502-1484

1014 Saint Andrews Blvd
Charleston, SC 29407
Phone (843) 556-5585

100 Jimmy Love Ln
Columbia, SC 29212
Phone (803) 731-4055

2246 Highway 17
Little River, SC 29566
Phone (843) 663-2220

8091 Rivers Ave
North Charleston, SC 29406
Phone (843) 572-7000

1714 Highway 17 S
North Myrtle Beach, SC 29582
Phone (803) 238-1461

410 N Main St
Summerville, SC 29483
Phone (843) 871-3277

1600 Highway 17 N
Surfside Beach, SC 29575
Phone (843) 238-1461

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1366471252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749306",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N MAIN ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836420",
            "telephone_number": "843-871-3277",
            "fax_number": "843-871-3360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1851 SAM RITTENBERG BLVD",
            "address_purpose": "LOCATION",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074861",
            "country_code": "US",
            "telephone_number": "843-556-5585",
            "fax_number": "843-556-5587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEEFE-TOMASELLO",
        "first_name": "JOANNE",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-02",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "1259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.