NPIMap

Organization Active NPI

Charleston Nephrology Associates, LLC

  • Nephrology Physician
  • North Charleston, SC
National Provider Identifier
1629054960
Registry record updated Oct 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
CHARLESTON NEPHROLOGY ASSOCIATES, LLC
Practice address
3815 Faber Place Dr
North Charleston, SC 29405-8533
Phone
(843) 767-9312
Fax
(843) 767-9313
NPI assigned
Dec 19, 2005
Last updated
Oct 18, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2007

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

Authorized official

Name
Mrs. Lane M Floyd
Title
Practice Administrator
Phone
(843) 767-9312

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X NU Primary

Addresses

Primary practice location

3815 Faber Place Dr
North Charleston, SC 29405-8533

Mailing address

3815 Faber Place Dr
North Charleston, SC 29405-8533
Phone (843) 767-9312

Other identifiers 2

IdentifierTypeStateIssuer
GP2517MedicaidSC
2517MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041008000278 SC Part B Supplier - Clinic/Group Practice 9638138209 Receives reassigned benefits from 22 practitioners
Practice locations: Goose Creek, SC; North Charleston, SC

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
42D0983798Charleston Nephrology Associates, LLC3815 Faber Place, North Charleston, SC 29405Provider-performed microscopyMar 4, 2027

National Provider Directory

National Provider Directory

Locations

2450 Elms Center Rd
North Charleston, SC 29406
Phone (843) 553-4742

3815 Faber Place Dr
North Charleston, SC 29405
Phone (843) 767-9260

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/0900078

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192665600000",
    "number": "1629054960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 FABER PLACE DR",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294058533",
            "telephone_number": "843-767-9312",
            "fax_number": "843-767-9313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 FABER PLACE DR",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294058533",
            "telephone_number": "843-767-9312",
            "fax_number": "843-767-9313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESTON NEPHROLOGY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-19",
        "last_updated": "2007-10-18",
        "status": "A",
        "authorized_official_last_name": "FLOYD",
        "authorized_official_first_name": "LANE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "843-767-9312",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2517",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2517",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.