Lowcountry Street Grocery

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

LOWCOUNTRY STREET GROCERY

Practice address

1108 Wappoo Rd
Charleston, SC 29407-5954

Phone

(843) 609-8188

NPI assigned

Apr 14, 2020

Last updated

Jun 28, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Olivia MyersNPI 1093112013

Title

Registered Dietitian

Phone

(304) 661-9975

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Olivia Rawlins Myers, R.D., L.D.

  • Registered Dietitian
  • Charleston, SC
  • NPI 1093112013

  Dietitian, Registered

  Medicare reassignment NPD Authorized official
• Keely Flynn Hudgins, MPH,RD, LD

  • Registered Dietitian
  • Charleston, SC
  • NPI 1043762743

  Dietitian, Registered

  Medicare reassignment NPD

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

{
    "created_epoch": "1586822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687910400000",
    "number": "1568081024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 WAPPOO RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294075954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 WAPPOO RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294075954",
            "telephone_number": "843-609-8188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOWCOUNTRY STREET GROCERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-14",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "OLIVIA",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "304-661-9975"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lowcountry Pediatric Therapy LLC
• Lowcountry Physical Therapy Associates LLC
• Lowcountry Psychiatry Inc.
• Lowcountry Psychotherapy Associates, P.a.
• Lowcountry Radiation Oncology, PA
• Lowcountry Surgery Center (Roper West Ashley Surgery Center)
• Lowcountry Surgery Center LLC (Roper St Francis Eye Center)
• Lowcountry Therapeutic
• Lowcountry Urology Clinics, PA
• Lowcountry Urology Clinics, PA

• Registered Dietitian in Charleston, SC
• Providers in Charleston, SC by specialty
• Registered Dietitian in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.

Verify at the official NPI Registry.