Individual provider Active NPI

Katherine Elizabeth Madden, NP

  • Family Nurse Practitioner
  • Charleston, SC
National Provider Identifier
1861843997
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
24712 Issued in SC
Practice address
354 Folly Rd Ste 5
Charleston, SC 29412-2594
Phone
(843) 225-2374
NPI assigned
Jun 30, 2016
Last updated
Oct 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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 RN249528 GA
Family Nurse Practitioner 363LF0000X 24712 SC Primary

Addresses

Primary practice location

354 Folly Rd Ste 5
Charleston, SC 29412-2594

Mailing address

PO Box 602645
Charlotte, NC 28260-2645
Phone (843) 789-1620

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
I20211209001577 SC Practitioner - Nurse Practitioner 4789979147 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Broad River Physicians Group, LLCGroup PAC ID 8123385143, 70 clinicians

Practice addresses (Care Compare)

316 Calhoun St
Charleston, SC 29401-1113
Phone (843) 724-2901

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN249528GAMDFamily Nurse Practitioner
24712SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Broad River Physicians Group, LLC CurrentSince Jan 1, 2023 Accepting new patients
Bon Secours St Francis Xavier Hospital, Inc. CurrentSince Oct 9, 2021 Accepting new patients
Bon Secours St. Francis Xavier Hospital, Inc. CurrentSince Oct 9, 2021 Accepting new patients

Locations

2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

2435 Forest Dr
Columbia, SC 29204
Phone (770) 874-6859

730 Stony Landing Rd
Moncks Corner, SC 29461
Phone (843) 572-9211

3500 N Highway 17
Mt Pleasant, SC 29466
Phone (843) 606-7000

7832 Rivers Ave
North Charleston, SC 29406
Phone (843) 824-8733

100 Callen Blvd
Summerville, SC 29486
Phone (845) 529-3165

101 Sawmill Centre Dr
Summerville, SC 29483

Interoperability endpoints

  • Direct secure messaging: katherine.madden.1@30093.direct.athenahealth.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1861843997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602645",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602645",
            "telephone_number": "843-789-1620",
            "fax_number": "843-724-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 FOLLY RD STE 5",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294122594",
            "telephone_number": "843-225-2374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDEN",
        "first_name": "KATHERINE",
        "middle_name": "ELIZABETH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-30",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN249528",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "24712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.