Charleston Brace Company, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

010748453 Issued in SC

Legal business name

CHARLESTON BRACE COMPANY, LLC

Practice address

9470A Highway 78
Ladson, SC 29456-3909

Phone

(843) 871-0600

Fax

(843) 871-6510

NPI assigned

Oct 2, 2006

Organization subpart

No

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

Authorized official

Name

Nathaniel Atha Jackson

Title

Owner

Phone

(843) 871-0600

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Charleston Brace Company, LLC

  • Prosthetic/Orthotic Supplier
  • Walterboro, SC
  • NPI 1063617629

  3274744735

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1720171929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9470A HIGHWAY 78",
            "city": "LADSON",
            "state": "SC",
            "postal_code": "294563909",
            "telephone_number": "843-871-0600",
            "fax_number": "843-871-6510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9470A HIGHWAY 78",
            "city": "LADSON",
            "state": "SC",
            "postal_code": "294563909",
            "telephone_number": "843-871-0600",
            "fax_number": "843-871-6510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESTON BRACE COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "NATHANIEL",
        "authorized_official_middle_name": "ATHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-871-0600"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "SC",
            "license": "010748453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Heather Chesler, CCC-SLP

• Prosthetic/Orthotic Supplier in Ladson, SC
• Providers in Ladson, SC by specialty
• Prosthetic/Orthotic Supplier in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.