Charles Effiong, MD
Individual provider Active NPI Internal Medicine Physician · Charleston, SC
NPI 1487604757 · NPPES record last updated Jul 21, 2015
Key facts
- NPI
- 1487604757
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 19174 (SC)
- Practice address
- 51 Nassau St
Charleston, SC 29403-5513 - Phone
- (843) 722-4112
- Fax
- (843) 577-8960
- NPI assigned
- May 10, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 20
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fetter Health Care Network Inc
Practice addresses (Care Compare)
106 W Main St
Moncks Corner, SC 29461-2601
Phone (843) 761-1995
130 Varnfield Dr
Suite 100
Summerville, SC 29483-7317
Phone (843) 821-3444
35 Walnut St
Charleston, SC 29403-4514
Phone (843) 723-9477
679 Orangeburg Rd
Unit F
Summerville, SC 29483-9038
Phone (843) 722-4112
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040708000013 | SC | Practitioner - Internal Medicine |
1658358668 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fetter Health Care Network, Inc. | Current |
Accepting new patients | |
| Fetter Health Care Network, Inc. | Current |
Accepting new patients | |
| Fetter Health Care Network, Inc. | Current |
Accepting new patients | |
| Fetter Health Care Network, Inc. | Current | Accepting new patients | |
| Fetter Health Care Network Inc | Current |
Accepting new patients | |
| Fetter Health Care Network, Inc. | Current |
Accepting new patients | |
| Fetter Health Care Network Inc | Past | Accepting new patients | |
| Nra-Mt. Pleasant, South Carolina, LLC | Past |
Accepting new patients | |
| Southeast Cardiology | Past |
Accepting new patients | |
| Nra-Hollywood, South Carolina, LLC | Past |
Accepting new patients | |
| Carolina Kidney & Hypertension Center, LLC | Nephrology | Past |
Accepting new patients |
Locations
35 Walnut St
Charleston, SC 29403
Phone (843) 723-9477
51 Nassau St
Charleston, SC 29403
403 Stony Landing Rd
Moncks Corner, SC 29461
Phone (843) 761-8282
106 W Main St
Moncks Corner, SC 29461
Phone (843) 761-1995
6401 Dorchester Rd
North Charleston, SC 29418
Phone (843) 207-3019
130 Varnfield Dr
Ste 100
Summerville, SC 29483
Phone (843) 821-3444
679 Orangeburg Rd
Unit F
Summerville, SC 29483
Phone (843) 261-2600
8548 Willtown Rd
Yonges Island, SC 29449
Phone (843) 723-9582
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 19174 | SC | |
| Internal Medicine Physician | 207R00000X | 19174 | SC | Yes |
Addresses
Primary practice location
51 Nassau St
Charleston, SC 29403-5513
Mailing address
P.O. Box 31093
Charleston, SC 29417
Phone (843) 573-0499
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 191740 | Medicaid | SC | |
| AA83436494 | Other | SC | MEDICARE PIN FETTER HEALTH CARE NETWORK |
Other providers in Charleston, SC
- Nyala Edwards
- Reid Taylor Edwards
- Scott Michael Edwards
- Shelley Rae Edwards
- William Milnes Edwards Jr.
- Cassandra L Effken
- Jamal Egbaria
- Katie Mantie Egbers
- Amber Egbert
- Maria F Egidi
All providers in Charleston, SC · Internal Medicine Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.