Magnolia Endocrinology, LLC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

Legal business name

MAGNOLIA ENDOCRINOLOGY, LLC

Practice address

204 Parsons Rd
Summerville, SC 29483-3348

Phone

(854) 201-3636

NPI assigned

Jan 30, 2020

Last updated

Jan 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Temple Mewshaw

Title

Owner

Phone

(854) 201-3636

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FHFACD

Practitioners 10

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.

• Rachel Grace Bengtson, PA

  • Physician Assistant
  • Summerville, SC
  • NPI 1174489736
  Medicare reassignment Care Compare group NPD
• Rebecca Provost Lawson, PA

  • Physician Assistant
  • Summerville, SC
  • NPI 1538921721
  Medicare reassignment Care Compare group NPD
• Rebecca Nelson

  • Physician Assistant
  • Ladson, SC
  • NPI 1558112946
  Medicare reassignment Care Compare group
• Temple Walker Simpson, PA-C

  • Medical Physician Assistant
  • Summerville, SC
  • NPI 1285822148
  Medicare reassignment Care Compare group
• Amy M. Turner, PA

  • Physician Assistant
  • Charleston, SC
  • NPI 1215261672
  Medicare reassignment Care Compare group
• Sarah Dolven, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Charleston, SC
  • NPI 1164430682
  Medicare reassignment NPD
• Katalina Romero Funke, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Ladson, SC
  • NPI 1386024099
  Medicare reassignment NPD
• Amelia G. Hill, FNP

  • Family Nurse Practitioner
  • Summerville, SC
  • NPI 1205316858
  Medicare reassignment NPD
• Kimberly B Pugh, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Clinton, SC
  • NPI 1912965831
  Medicare reassignment NPD
• John Bennett Schenck, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Summerville, SC
  • NPI 1942362793
  Medicare reassignment NPD

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642723200000",
    "number": "1922639897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 PARSONS RD",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294833348",
            "telephone_number": "854-201-3636",
            "fax_number": "854-201-1983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 PARSONS RD",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294833348",
            "telephone_number": "854-201-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA ENDOCRINOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-30",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A",
        "authorized_official_last_name": "MEWSHAW",
        "authorized_official_first_name": "TEMPLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "854-201-3636"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "K109",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Randall Mackendrick, M.ED., LPC
• Bernadette Payne Macleod, CPNP
• Patricia F. Maderson, LISW
• Magnolia Children's Therapy
• Magnolia Counseling
• Magnolia Family Dental LLC
• Magnolia Mental Health, LLC
• Magnolia Speech and Language, LLC
• Bernice Magwood
• Thomas Maino, M.D.

• Endocrinology, Diabetes & Metabolism Physician in Summerville, SC
• Providers in Summerville, SC by specialty
• Endocrinology, Diabetes & Metabolism Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.