Ebbtide Comprehensive Care, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

EBBTIDE COMPREHENSIVE CARE, LLC

Practice address

1064 Gardner Rd Ste 105-106
Charleston, SC 29407-5768

Phone

(843) 491-9955

NPI assigned

Dec 1, 2023

Last updated

Dec 1, 2023By 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

Corynne Boyer, MDNPI 1912138983

Title

Owner

Phone

(843) 491-9955

Specialties & licenses 1

Addresses

Locations

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.

• Corynne Boyer, D.O.

  • Internal Medicine Physician
  • Goose Creek, SC
  • NPI 1912138983
  NPD Authorized official

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

{
    "created_epoch": "1701388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701388800000",
    "number": "1932975711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "669 MARINA DR STE A2",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294927573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1064 GARDNER RD STE 105-106",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294075768",
            "telephone_number": "843-491-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBBTIDE COMPREHENSIVE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-01",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A",
        "authorized_official_last_name": "BOYER",
        "authorized_official_first_name": "CORYNNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-491-9955",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert S. Easterling, MD
• Sonya F Easterling, MA
• Julie Ann Eastman, CRNA
• Easy Talk Pediatrics, LLC
• Ebbtide Comprehensive Care
• Ebenezer Social Action and Community Development Enterprise (Ebenezer Senior Day Center)
• Sean Donald Eberhard, APRN
• Allie Eberly, MD
• Livy Fogle Eberly, PH.D.
• Jody K Eblen, ANP

• Internal Medicine Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Internal Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; 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.