SRP Medical LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

SRP MEDICAL LLC

Practice address

1445 Bluewater Way
Charleston, SC 29414-7923

Phone

(407) 516-3756

NPI assigned

May 13, 2025

Organization subpart

No

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

Authorized official

Name

Sonya R Puckett, APRN-AGACNPNPI 1982091831

Title

Owner

Phone

(407) 516-3756

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Practitioners 1

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.

• Sonya Renee Puckett, APRN

  • Nurse Practitioner
  • Columbia, SC
  • NPI 1982091831
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1747094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747094400000",
    "number": "1881485662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "742 SAINT ANDREWS BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077169",
            "telephone_number": "407-516-3756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 BLUEWATER WAY",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294147923",
            "telephone_number": "407-516-3756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRP MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-13",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A",
        "authorized_official_last_name": "PUCKETT",
        "authorized_official_first_name": "SONYA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-516-3756",
        "authorized_official_credential": "APRN-AGACNP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sreesh Sridhar, MD
• Siddharth Srikakolapu, MD
• Ganga L Srinivas, MD
• Niharika Srivastava, DO
• Romik Prakash Srivastava, MD
• St Andrews Medical Inc
• St. Andrew's Parish Parks and Playground Commission
• St. Andrews Psychiatric Services, LLC
• St. Andrews Urgent Care, PC (Doctors Express)
• Katherine Ann St. Germain, D.O.

• Nurse Practitioner in Charleston, SC
• Providers in Charleston, SC by specialty
• Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.

Verify at the official NPI Registry.