NPIMap

Organization Active NPI

Liberty Doctors LLC

Doing business as Charles Towne Pediatrics

  • Pediatrics Physician
  • Charleston, SC
National Provider Identifier
1558928614
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
LIBERTY DOCTORS LLC
Doing business as
Charles Towne Pediatrics
Practice address
8761 Dorchester Rd Ste 100
Charleston, SC 29420-7320
Phone
(843) 747-4647
Fax
(843) 745-0969
NPI assigned
May 23, 2019
Last updated
Mar 26, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
LIBERTY DOCTORS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

8761 Dorchester Rd Ste 100
Charleston, SC 29420-7320

Mailing address

PO Box 13955
Charleston, SC 29422-3955
Phone (843) 225-8320

Other identifiers 1

IdentifierTypeStateIssuer
GP6738MedicaidSC

Other names 1

  • Charles Towne Pediatrics Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D0250921Charles Towne Pediatrics8761 Dorchester Road Suite 100, North Charleston, SC 29420Provider-performed microscopyOct 28, 2027

National Provider Directory

National Provider Directory
Tax ID family
Liberty Doctors LLC12 organizations share this tax ID, including this one
Part of
Liberty Doctors LLC

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774483200000",
    "number": "1558928614",
    "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": "843-225-8320",
            "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": "CHARLESTON",
            "state": "SC",
            "postal_code": "294207320",
            "telephone_number": "843-747-4647",
            "fax_number": "843-745-0969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY DOCTORS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIBERTY DOCTORS LLC",
        "enumeration_date": "2019-05-23",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "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": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP6738",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charles Towne Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.