St. Andrews Psychiatric Services, LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

ST. ANDREWS PSYCHIATRIC SERVICES, LLC

Practice address

669 Saint Andrews Blvd
Charleston, SC 29407-7165

Phone

(843) 367-2716

Fax

(843) 556-0300

NPI assigned

Jul 6, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Darlene H Moak, M.D.NPI 1659323830

Title

Owner / Member

Phone

(843) 327-2716

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Darlene H Moak, M.D.

  • Psychiatry Physician
  • Charleston, SC
  • NPI 1659323830
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196380800000",
    "number": "1922039940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "669 SAINT ANDREWS BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077165",
            "telephone_number": "843-367-2716",
            "fax_number": "843-556-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "669 SAINT ANDREWS BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077165",
            "telephone_number": "843-367-2716",
            "fax_number": "843-556-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. ANDREWS PSYCHIATRIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-11-30",
        "status": "A",
        "authorized_official_last_name": "MOAK",
        "authorized_official_first_name": "DARLENE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER / MEMBER",
        "authorized_official_telephone_number": "843-327-2716",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4054",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Niharika Srivastava, DO
• Romik Prakash Srivastava, MD
• SRP Medical LLC
• St Andrews Medical Inc
• St. Andrew'S Parish Parks and Playground Commission
• St. Andrews Urgent Care, PC
• Katherine Ann St. Germain, D.O.
• Kiely McCrea St. Germain, APRN
• Dwayne St. Thomas, MED
• Kenneth M Stabile, BC-HIS

• Psychiatry Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Psychiatry Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; 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.