Organization Active NPI

Adolescent Medicine Associates

  • Adolescent Medicine (Family Medicine) Physician
  • Mount Pleasant, SC
National Provider Identifier
1922022417
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Family Medicine) PhysicianTaxonomy code 207QA0000X
License
207QA0000X Issued in SC
Legal business name
ADOLESCENT MEDICINE ASSOCIATES
Practice address
900 Bowman Rd
Suite 304
Mt Pleasant, SC 29464-3203
Phone
(843) 884-1217
Fax
(843) 884-7796
NPI assigned
Jul 27, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Sharon R Owens, CPC
Title
Office Manager
Phone
(843) 884-1217

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Family Medicine) Physician 207QA0000X 207QA0000X SC Primary

Addresses

Primary practice location

900 Bowman Rd
Suite 304
Mt Pleasant, SC 29464-3203

Mailing address

900 Bowman Rd
Suite 304
Mt Pleasant, SC 29464-3203
Phone (843) 884-1217

National Provider Directory

National Provider Directory

Locations

900 Bowman Rd
Ste 304
Mt Pleasant, SC 29464
Phone (843) 884-1217

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922022417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 BOWMAN RD",
            "address_2": "SUITE 304",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643203",
            "telephone_number": "843-884-1217",
            "fax_number": "843-884-7796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 BOWMAN RD",
            "address_2": "SUITE 304",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643203",
            "telephone_number": "843-884-1217",
            "fax_number": "843-884-7796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADOLESCENT MEDICINE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OWENS",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "843-884-1217",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "SC",
            "license": "207QA0000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.