Individual provider Active NPI

Kathleen Mary Ronin, D.O

  • Pediatrics Physician
  • Charleston, SC
National Provider Identifier
1487034880
Registry record updated Jul 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
37665 Issued in SC
Practice address
2051 Charlie Hall Blvd
Charleston, SC 29414
Phone
(843) 573-2535
Fax
(843) 573-2534
NPI assigned
Jun 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 37665 SC Primary

Addresses

Primary practice location

2051 Charlie Hall Blvd
Charleston, SC 29414

Mailing address

2051 Charlie Hall Blvd
Charleston, SC 29414-5834
Phone (843) 573-2535

Other practice location 1

9165 University Blvd Ste 100
North Charleston, SC 29406-7133
Phone (843) 284-4255

Other practice location 2

1952 Long Grove Dr Ste 202
Mount Pleasant, SC 29464-7579
Phone (843) 971-2992

Other practice location 3

776 Daniel Ellis Dr Ste A
Charleston, SC 29412-3094
Phone (843) 795-8100

Other practice location 4

2015 2nd Ave Ste 101
Summerville, SC 29486-7881
Phone (843) 737-9465

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151107000054 SC Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 2466762299

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37665SCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Family Care, Inc Pediatrics Past Accepting new patients
Coastal Pediatric Associates, P.a. Pediatrics PastSince Apr 1, 2021 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532044800000",
    "number": "1487034880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 CHARLIE HALL BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145834",
            "telephone_number": "843-573-2535",
            "fax_number": "843-573-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 CHARLIE HALL BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29414",
            "telephone_number": "843-573-2535",
            "fax_number": "843-573-2534"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9165 University Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "North Charleston",
            "state": "SC",
            "postal_code": "294067133",
            "country_code": "US",
            "telephone_number": "843-284-4255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1952 Long Grove Dr Ste 202",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "SC",
            "postal_code": "294647579",
            "country_code": "US",
            "telephone_number": "843-971-2992",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "776 Daniel Ellis Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294123094",
            "country_code": "US",
            "telephone_number": "843-795-8100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2015 2nd Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Summerville",
            "state": "SC",
            "postal_code": "294867881",
            "country_code": "US",
            "telephone_number": "843-737-9465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RONIN",
        "first_name": "KATHLEEN",
        "middle_name": "MARY",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-02",
        "last_updated": "2018-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "37665",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 20, 2018; 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.