NPIMap

Individual provider Active NPI

Amanda Walsh, MD

  • Otolaryngology Physician
  • Charleston, SC
National Provider Identifier
1487114732
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
91656 Issued in SC
Practice address
2295 Henry Tecklenburg Dr
Charleston, SC 29414-7801
Phone
(843) 766-7103
Fax
(843) 377-4629
NPI assigned
Mar 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 91656 SC Primary

Addresses

Primary practice location

2295 Henry Tecklenburg Dr
Charleston, SC 29414-7801

Mailing address

2295 Henry Tecklenburg Dr
Charleston, SC 29414-7801
Phone (843) 766-7103

Other practice location 1

403 Faison Rd
Mount Pleasant, SC 29466-8507
Phone (843) 766-7103

Other practice location 2

622 Johnnie Dodds Blvd
Mount Pleasant, SC 29464-3013
Phone (843) 766-7103

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240430003133 SC Practitioner - Otolaryngology 1052751682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charleston ENT Associates, LLCGroup PAC ID 4082662234, 77 clinicians

Practice addresses (Care Compare)

2295 Henry Tecklenburg Dr
Charleston, SC 29414-7801
Phone (843) 766-7103

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
91656SCMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston ENT Associates, LLC Otolaryngology CurrentSince May 2, 2024 Accepting new patients
Charleston ENT Associates, LLC CurrentSince May 2, 2024 Accepting new patients

Locations

2295 Henry Tecklenburg Dr
Charleston, SC 29414

1849 Savage Rd
Charleston, SC 29407
Phone (843) 576-2600

403 Faison Rd
Mount Pleasant, SC 29466

622 Johnnie Dodds Blvd
Mt Pleasant, SC 29464

Interoperability endpoints

  • Direct secure messaging: amanda.walsh.p1@direct.entap.nextgenshare.com

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1487114732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2295 HENRY TECKLENBURG DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294147801",
            "telephone_number": "843-766-7103",
            "fax_number": "843-377-4629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2295 HENRY TECKLENBURG DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294147801",
            "telephone_number": "843-766-7103",
            "fax_number": "843-377-4629"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "403 Faison Rd",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "SC",
            "postal_code": "294668507",
            "country_code": "US",
            "telephone_number": "843-766-7103",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "622 Johnnie Dodds Blvd",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "SC",
            "postal_code": "294643013",
            "country_code": "US",
            "telephone_number": "843-766-7103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALSH",
        "first_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-22",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "SC",
            "license": "91656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.