Individual provider Active NPI

Kelli Elizabeth Johnston, D.O.

  • Pediatrics Physician
  • Johns Island, SC
National Provider Identifier
1689797268
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
927 Issued in SC
Practice address
3312 Maybank Hwy Ste B
Johns Island, SC 29455-4818
Phone
(843) 894-3490
Fax
(833) 450-6022
NPI assigned
Apr 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 927 SC Primary

Addresses

Primary practice location

3312 Maybank Hwy Ste B
Johns Island, SC 29455-4818

Mailing address

2911 Waterleaf Rd
Johns Island, SC 29455-3176
Phone (843) 894-3490

Other identifiers 1

IdentifierTypeStateIssuer
009270MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210708000646 SC Practitioner - Pediatric Medicine 1052713492 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Pediatric Associates, P.a. Pediatrics CurrentSince Jul 1, 2021 Accepting new patients
Angel Oak Pediatrics LLC Pediatrics CurrentSince Nov 26, 2023 Accepting new patients

Locations

2067 Charlie Hall Blvd
Charleston, SC 29414
Phone 8435732535 ext. 3215

2051 Charlie Hall Blvd
Charleston, SC 29414
Phone (843) 573-2535

3312 Maybank Hwy
#B
Johns Island, SC 29455
Phone (843) 557-1700

1834 Bluebird Rd
Ofc 7
Johns Island, SC 29455

3312 Maybank Hwy
Johns Island, SC 29455
Phone (803) 762-4752

4975 Lacross Rd
Ste 150
North Charleston, SC 29406
Phone (843) 573-2535

2015 2nd Ave
Ste 101
Summerville, SC 29486
Phone (843) 573-2535

Interoperability endpoints

  • Direct secure messaging: kelli.johnston.1@30388.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1689797268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 WATERLEAF RD",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "294553176",
            "telephone_number": "843-894-3490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3312 MAYBANK HWY STE B",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "294554818",
            "telephone_number": "843-894-3490",
            "fax_number": "833-450-6022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "KELLI",
        "middle_name": "ELIZABETH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009270",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Island, SC

Sources for this page

Verify at the official NPI Registry.