Lowcountry Street Grocery
Organization Active NPI Registered Dietitian · Charleston, SC
NPI 1568081024 · NPPES record last updated Jun 28, 2023
Key facts
- NPI
- 1568081024
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Registered Dietitian 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
- Organization subpart
- No
Authorized official
- Name
- Olivia Myers
- Title
- Registered Dietitian
- Phone
- (304) 661-9975
Practitioners 2
-
Olivia Rawlins Myers, R.D., L.D.
-
Keely Flynn Hudgins, MPH,RD, LD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220907003032 | SC | Part B Supplier - Clinic/Group Practice | 5395129571 |
Receives reassigned benefits from 2 practitioners Practice locations: Charleston, SC |
National Provider Directory
Locations
1108 Wappoo Rd
Ste 2
Charleston, SC 29407
Phone (843) 609-8188
1630 Meeting Street Rd
Charleston, SC 29405
1108 Wappoo Rd
Charleston, SC 29407
Phone (843) 609-8188
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian |
133V00000X | Yes |
Addresses
Primary practice location
1108 Wappoo Rd
Charleston, SC 29407-5954
Mailing address
1108 Wappoo Rd
Charleston, SC 29407-5954
Other providers in Charleston, SC
- Lowcountry Pediatric Therapy LLC
- Lowcountry Physical Therapy Associates LLC
- Lowcountry Psychiatry Inc.
- Lowcountry Psychotherapy Associates, P.a.
- Lowcountry Radiation Oncology, PA
- Lowcountry Surgery Center
- Lowcountry Surgery Center LLC
- Lowcountry Therapeutic
- Lowcountry Urology Clinics, PA
- Lowcountry Urology Clinics, PA
All providers in Charleston, SC · Registered Dietitian 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 Jun 28, 2023. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.