Individual provider Active NPI

Katherine B. Holbrook, APRN

  • Family Nurse Practitioner
  • North Charleston, SC
National Provider Identifier
1770019531
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20938 Issued in SC
Practice address
2600 Elms Plantation Blvd
North Charleston, SC 29406-9164
Phone
(800) 491-0909
Fax
(843) 782-4044
NPI assigned
May 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 22452 TN
Family Nurse Practitioner 363LF0000X 20938 SC Primary

Addresses

Primary practice location

2600 Elms Plantation Blvd
North Charleston, SC 29406-9164

Mailing address

1624 Main Street
Agape Senior Primary Care, Inc.
Columbia, SC 29201-2818
Phone (803) 726-2283

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170718000388 SC Practitioner - Nurse Practitioner 4981974367 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22452TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SC House Calls Inc CurrentSince Jun 1, 2017 Accepting new patients
SC House Calls Inc CurrentSince Jun 1, 2017 Accepting new patients

Locations

1624 Main St
Columbia, SC 29201
Phone (803) 454-0365

2600 Elms Plantation Blvd
North Charleston, SC 29406
Phone (843) 574-7840

1053 Center St
West Columbia, SC 29169
Phone (803) 454-0365

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": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1770019531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1624 MAIN STREET",
            "address_2": "AGAPE SENIOR PRIMARY CARE, INC.",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012818",
            "telephone_number": "803-726-2283",
            "fax_number": "803-753-9102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 ELMS PLANTATION BLVD",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069164",
            "telephone_number": "800-491-0909",
            "fax_number": "843-782-4044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLBROOK",
        "first_name": "KATHERINE",
        "middle_name": "B.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "22452",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "20938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

Verify at the official NPI Registry.