Individual provider Active NPI

Brooke S. Plewinski, PA

  • Medical Physician Assistant
  • Charleston, SC
National Provider Identifier
1902068984
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2273 Issued in SC
Practice address
669 Marina Dr Ste A2
Charleston, SC 29492-7573
Phone
(843) 491-9960
NPI assigned
Jun 30, 2008
Last updated
Jul 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2273 SC Primary

Addresses

Primary practice location

669 Marina Dr Ste A2
Charleston, SC 29492-7573

Mailing address

PO Box 751874
Charlotte, NC 28275-1874
Phone (843) 402-5200

Other practice location 1

1064 Gardner Rd Ste 105-106
Charleston, SC 29407-5768
Phone (843) 491-9960

Other practice location 2

110B Springhall Dr
Goose Creek, SC 29445-5335
Phone (843) 491-9960

Other identifiers 1

IdentifierTypeStateIssuer
2525PAMedicaidSC

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
I20160301001723 SC Practitioner - Physician Assistant 1254408081 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ebbtide Comprehensive Care CurrentSince Aug 1, 2025 Accepting new patients
Liberty Doctors LLC CurrentSince Jun 17, 2023 Accepting new patients
Bon Secours St Francis Xavier Hospital, Inc. CurrentSince Nov 6, 2022 Accepting new patients
Bon Secours St. Francis Xavier Hospital, Inc. CurrentSince Nov 6, 2022 Accepting new patients
Liberty Doctors LLC Past Accepting new patients
First Stop Urgent Care Center PSC Past Accepting new patients
Liberty Doctors LLC Dba Ebb Tide Comprehensive Care PastSince Jan 7, 2024 Accepting new patients

Locations

1064 Gardner Rd
Ste 105106
Charleston, SC 29407
Phone (843) 491-9955

1315 Ashley River Rd
Charleston, SC 29407
Phone (843) 491-9955

2085 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 577-6957

418 Folly Rd
#A
Charleston, SC 29412
Phone (843) 225-8320

669 Marina Dr
Ste A
Charleston, SC 29492

669 Marina Dr
Ste A2
Daniel Island, SC 29492
Phone (843) 491-9955

110 Springhall Dr
Ste B
Goose Creek, SC 29445
Phone (843) 491-9955

2910 Tricom St
North Charleston, SC 29406
Phone (843) 572-9211

2910 Tricom St
Ste 100
North Charleston, SC 29406
Phone (843) 572-9211

8761 Dorchester Rd
Ste 230
North Charleston, SC 29420
Phone (843) 225-8320

Interoperability endpoints

  • Direct secure messaging: bplewinski@libertydoctors.ssdirect.aprima.com

Organizations & group practices 8

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": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1902068984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751874",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751874",
            "telephone_number": "843-402-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "669 MARINA DR STE A2",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294927573",
            "telephone_number": "843-491-9960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1064 Gardner Rd Ste 105-106",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294075768",
            "country_code": "US",
            "telephone_number": "843-491-9960",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110B Springhall Dr",
            "address_purpose": "LOCATION",
            "city": "Goose Creek",
            "state": "SC",
            "postal_code": "294455335",
            "country_code": "US",
            "telephone_number": "843-491-9960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PLEWINSKI",
        "first_name": "BROOKE",
        "middle_name": "S.",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-30",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "2273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2525PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.