Individual provider Active NPI

Karissa Katherine Adams, PHD

  • Psychologist
  • Charleston, SC
National Provider Identifier
1992992044
Registry record updated Oct 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1062 Issued in SC
Practice address
1744 Sam Rittenberg Blvd Ste A3
Charleston, SC 29407-4943
Phone
(843) 364-5564
NPI assigned
Oct 2, 2007
Last updated
Oct 2, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1062 SC Primary

Addresses

Primary practice location

1744 Sam Rittenberg Blvd Ste A3
Charleston, SC 29407-4943

Mailing address

1744 Sam Rittenberg Blvd Ste A3
Charleston, SC 29407-4943
Phone (843) 364-5564

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120913000805 SC Practitioner - Psychologist Billing Independently 0749438802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of North Dakota School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1744 Sam Rittenberg Blvd
A3
Charleston, SC 29407-4943
Phone (843) 364-5564

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1062SCMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Karissa Adams, PH.D. LLC Psychologist CurrentSince Oct 10, 2012 Accepting new patients

Locations

1744 Sam Rittenberg Blvd
Ste A
Charleston, SC 29407
Phone (843) 364-5564

1744 Sam Rittenberg Blvd
Ste A3
Charleston, SC 29407
Phone (843) 364-5564

Organizations & group practices 1

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": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191283200000",
    "number": "1992992044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1744 SAM RITTENBERG BLVD STE A3",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074943",
            "telephone_number": "843-364-5564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1744 SAM RITTENBERG BLVD STE A3",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074943",
            "telephone_number": "843-364-5564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "KARISSA",
        "middle_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-02",
        "last_updated": "2007-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "SC",
            "license": "1062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; 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.