Active NPI
Liberty Doctors, LLC
- Family Medicine Physician
- North Charleston, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- LIBERTY DOCTORS, LLC
- Practice address
- 8761 Dorchester Rd Ste 100
North Charleston, SC 29420-7320 - Phone
- (843) 767-3323
- Fax
- (843) 767-4252
- NPI assigned
- Dec 15, 2006
- Organization subpart
- Yes
- Parent organization
- LIBERTY DOCTORS, LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Chelsey Dever
- Title
- Credentialing Coordinator
- Phone
- (843) 225-8320
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 17172 | SC | |
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
8761 Dorchester Rd Ste 100
North Charleston, SC 29420-7320
Mailing address
PO Box 13955
Charleston, SC 29422-3955
Phone (843) 225-8304
Other practice location 1
6518 Dorchester Rd Ste B
Charleston, SC 29418-5100
Phone (843) 767-3323
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP6738 | Medicaid | SC |
Other names 1
- Dr. Heather Dawson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
Other NPIs on the same Medicare enrollment 6
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Family Medicine Physician
- Hartsville, SC
- NPI 1194122598
O20120110000683
-
- Internal Medicine Physician
- Charleston, SC
- NPI 1316218670
O20120110000683
National Provider Directory
National Provider Directory- Part of
- Liberty Doctors LLC Dba Ebb Tide Comprehensive Care
Locations
215 Town Creek Rd
Aiken, SC 29803
Phone (803) 508-7651
1064 Gardner Rd
Ste 105106
Charleston, SC 29407
Phone (843) 491-9955
669 Marina Dr
Charleston, SC 29492
Phone (843) 225-8304
1025 W Meeting St
Ste 200
Lancaster, SC 29720
Phone (803) 285-1082
1025 W Meeting St
Lancaster, SC 29720
Phone (803) 286-5223
6518 Dorchester Rd
Ste B
North Charleston, SC 29418
Phone (843) 767-3323
102 Harth Pl
Summerville, SC 29485
Phone (843) 832-6425
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Charleston, SC
- NPI 1548240559
-
- Internal Medicine Physician
- Goose Creek, SC
- NPI 1912138983
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166140800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1698105600000",
"number": "1508928656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 13955",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294223955",
"telephone_number": "843-225-8304",
"fax_number": "843-225-3549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8761 DORCHESTER RD STE 100",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "294207320",
"telephone_number": "843-767-3323",
"fax_number": "843-767-4252"
}
],
"practiceLocations": [
{
"address_1": "6518 Dorchester Rd Ste B",
"address_purpose": "LOCATION",
"city": "Charleston",
"state": "SC",
"postal_code": "294185100",
"country_code": "US",
"telephone_number": "843-767-3323",
"fax_number": "843-767-4252",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "LIBERTY DOCTORS, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "LIBERTY DOCTORS, LLC",
"enumeration_date": "2006-12-15",
"last_updated": "2023-10-24",
"certification_date": "2023-10-24",
"status": "A",
"authorized_official_last_name": "DEVER",
"authorized_official_first_name": "CHELSEY",
"authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
"authorized_official_telephone_number": "843-225-8320"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist",
"state": "SC",
"license": "17172",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GP6738",
"state": "SC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Dr. Heather Dawson",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Dr. Heather Dawson",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in North Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.