Individual provider Active NPI

Calvin Jon Bosman, M.D.

  • Psychiatry Physician
  • Charleston, SC
National Provider Identifier
1467534370
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
28183 Issued in SC
Practice address
204 W Hill Blvd
Charleston, SC 29404-4704
Phone
(843) 963-6852
NPI assigned
Oct 19, 2006
Last updated
Sep 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 28183 SC Primary

Addresses

Primary practice location

204 W Hill Blvd
Charleston, SC 29404-4704

Mailing address

204 W Hill Blvd
Charleston, SC 29404-4704

Other identifiers 1

IdentifierTypeStateIssuer
281830MedicaidSC

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080303000663 SC Practitioner - Psychiatry 6305920141 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28183SCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Calvin Jonathan Bosman LLC Psychiatry CurrentSince May 1, 2012 Accepting new patients
Lowcountry Wellness Center LLC PastSince Sep 10, 2017 Accepting new patients

Locations

2777 Speissegger Dr
North Charleston, SC 29405
Phone (843) 266-7080

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1467534370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 W HILL BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294044704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W HILL BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294044704",
            "telephone_number": "843-963-6852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSMAN",
        "first_name": "CALVIN",
        "middle_name": "JON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "28183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281830",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.