Active NPI
Athena Consulting LLC
- Internal Medicine Physician
- North Charleston, SC
National Provider Identifier
1679316889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- ATHENA CONSULTING LLC
- Practice address
- 3842 Leeds Ave Unit C
North Charleston, SC 29405-7460 - Phone
- (843) 747-6634
- NPI assigned
- Jun 15, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tyler Stout
- Title
- Manager
- Phone
- (337) 315-7927
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Wound Care Registered Nurse | 163WW0000X | |||
| Internal Medicine Physician | 207R00000X | Primary | ||
| Physician Assistant | 363A00000X | |||
| Nurse Practitioner | 363L00000X |
Addresses
Primary practice location
3842 Leeds Ave Unit C
North Charleston, SC 29405-7460
Mailing address
3842 Leeds Ave Unit C
North Charleston, SC 29405-7460
Phone (843) 747-6634
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
3842 Leeds Ave
Unit C
North Charleston, SC 29405
Phone (843) 747-6634
Practitioners & affiliated clinicians
Practitioners 6
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.
-
- Family Nurse Practitioner
- N Charleston, SC
- NPI 1790035509
-
- Internal Medicine Physician
- Mount Pleasant, SC
- NPI 1013969393
-
- Physician Assistant
- Mount Pleasant, SC
- NPI 1376822627
-
- Family Nurse Practitioner
- North Charleston, SC
- NPI 1144636192
-
- Hospitalist Physician
- Charleston, SC
- NPI 1437773496
-
- Medical Physician Assistant
- Mount Pleasant, SC
- NPI 1316228679
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718409600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1762128000000",
"number": "1679316889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3842 LEEDS AVE UNIT C",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "294057460",
"telephone_number": "843-747-6634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3842 LEEDS AVE UNIT C",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "294057460",
"telephone_number": "843-747-6634"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ATHENA CONSULTING LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-06-15",
"last_updated": "2025-11-03",
"certification_date": "2025-11-03",
"status": "A",
"authorized_official_last_name": "STOUT",
"authorized_official_first_name": "TYLER",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "337-315-7927"
},
"taxonomies": [
{
"code": "163WW0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Registered Nurse, Wound Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"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 Nov 3, 2025; 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.