Amanda Polhemus

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

R240798 Issued in MD

Practice address

198 Rutledge Avenue
Suite 1
Charleston, SC 29403

Phone

(843) 723-0855

Fax

(843) 723-1307

NPI assigned

Oct 22, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Southern Medical Management, LLC

  • Pediatrics Physician
  • Lexington, SC
  • NPI 1114196557
  NPD (past)
• Sweetgrass Pediatrics

  • Pediatrics Physician
  • North Charleston, SC
  • NPI 1437168135
  NPD (past)
• Kidzcare Pediatrics, PC

  • Pediatrics Physician
  • Hope Mills, NC
  • NPI 1679529051
  NPD (past)

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

{
    "created_epoch": "1571702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1508409541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2214 OLD CHEROKEE ROAD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "29072",
            "telephone_number": "803-520-9380",
            "fax_number": "803-520-5972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 RUTLEDGE AVENUE",
            "address_2": "SUITE 1",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29403",
            "telephone_number": "843-723-0855",
            "fax_number": "843-723-1307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLHEMUS",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-22",
        "last_updated": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "R240798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Poindexter
• Pointe Dialysis LLC
• Jonathan Poirier, D.O.
• Pooja Poladia, PHARMD
• Polestar Health and Wellness
• Cynthia Poliard, PT
• Ashley Nicole Rose Polk
• James Polk, DO
• Jasmine Kyla Polkowske, MD
• Ross B Pollack, MD

• Pediatric Nurse Practitioner in Charleston, SC
• Providers in Charleston, SC by specialty
• Pediatric Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.