NPIMap

Organization Active NPI

Liberty Doctors, LLC

Doing business as Carolina Family Medicine

  • Family Medicine Physician
  • Goose Creek, SC
National Provider Identifier
1376593350
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LIBERTY DOCTORS, LLC
Doing business as
Carolina Family Medicine
Practice address
100 Springhall Dr
Goose Creek, SC 29445-5335
Phone
(843) 572-8201
Fax
(843) 797-8491
NPI assigned
May 11, 2006
Organization subpart
Yes
Parent organization
LIBERTY DOCTORS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Authorized official

Name
Chelsey Dever
Title
Credentialing Coordinator
Phone
(843) 225-8320

Specialties & licenses 1

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

Addresses

Primary practice location

100 Springhall Dr
Goose Creek, SC 29445-5335

Mailing address

PO Box 13955
Charleston, SC 29422-3955
Phone (843) 225-8304

Other identifiers 3

IdentifierTypeStateIssuer
GP0189MedicaidSC
GP6738MedicaidSC
GP0189OtherSCMEDICAID GROUP NUMBER

Other names 1

  • Carolina Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120110000683 SC Part B Supplier - Clinic/Group Practice 0840466017 Receives reassigned benefits from 69 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Aiken, SC; Summerville, SC; North Charleston, SC; Moncks Corner, SC; Lancaster, SC; Indian Land, SC; Goose Creek, SC; Edisto Island, SC…

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Liberty Doctors LLC

Locations

100 Springhall Dr
Goose Creek, SC 29445
Phone (843) 572-8201

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765756800000",
    "number": "1376593350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13955",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294223955",
            "telephone_number": "843-225-8304",
            "fax_number": "843-225-3549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SPRINGHALL DR",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294455335",
            "telephone_number": "843-572-8201",
            "fax_number": "843-797-8491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY DOCTORS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIBERTY DOCTORS LLC",
        "enumeration_date": "2006-05-11",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A",
        "authorized_official_last_name": "DEVER",
        "authorized_official_first_name": "CHELSEY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "843-225-8320"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0189",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP6738",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP NUMBER",
            "identifier": "GP0189",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolina Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Carolina Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Goose Creek, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.