LIBERTY DOCTORS, LLC (NPI# 1194380162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194380162 |
| Entity Type | Organization |
| Organization Name | LIBERTY DOCTORS, LLC |
| Other Organization Name | LAURA LEE KINNEY MD |
| Practice Address |
2270 Ashley Crossing Dr Ste 165 Charleston SC 29414-5865 |
| Mailing Address |
Po Box 13955 Charleston SC 29422-3955 |
| Practice Telephone | 8439364455 |
| Practice Fax Number | 8432682670 |
| Mailing Telephone | 8432258320 |
| Mailing Fax Number | 8432253549 |
| Enumeration Date | 2019-05-06 |
| Last Update Date | 2019-09-09 |
| Authorized Official Name | SARA ELIZABETH MAYNOR-HARDY (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 8432258320 |
| Is Organization Subpart | Y |
| Parent Organization Name | LIBERTY DOCTORS, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP6738 | 05 | |
| SC | MEDICARE PTAN | A634 | 01 |
| SC | 194667 | 05 |
| Other Name | Type Code |
|---|---|
| Laura Lee Kinney MD | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821443896 | Liberty Doctors, LLC | Family Medicine | 9275 D Medical Plaza Dr., North Charleston, SC 29406 | 2016-04-27 |
| 1376854406 | Liberty Doctors, LLC | Family Medicine | 8761 Dorchester Rd, Suite 230, North Charleston, SC 29420-7322 | 2010-06-23 |
| 1144421330 | Liberty Doctors, LLC | Family Medicine | 1405 Ben Sawyer Blvd, Ste 105, Mt Pleasant, SC 29464 | 2007-05-29 |
| 1508928656 | Liberty Doctors, LLC | Specialist | 6518 Dorchester Rd Ste B, Charleston, SC 29418-5100 | 2006-12-15 |
| 1053954909 | Liberty Doctors, LLC | Family Medicine | 297 Seven Farms Dr Ste 202, Daniel Island, SC 29492-7553 | 2019-10-23 |
| 1588119556 | Liberty Doctors, LLC | Pediatrics | 215 Town Creek Rd, Aiken, SC 29803-5843 | 2016-08-19 |
| 1689129652 | Liberty Doctors, LLC | Family Medicine | 21 Gamecock Ave, Charleston, SC 29407-3368 | 2016-08-19 |
| 1689051369 | Liberty Doctors, LLC | Family Medicine | 418 Folly Rd Ste A, Charleston, SC 29412-2625 | 2015-05-01 |
| 1881639862 | Liberty Doctors, LLC | Family Medicine | 1483 Tobias Gadson Blvd, Suite 206, Charleston, SC 29407-8702 | 2006-06-16 |
| 1376593350 | Liberty Doctors, LLC | Specialist | 100 Springhall Dr, Goose Creek, SC 29445-5335 | 2006-05-11 |
| Street Address |
2270 ASHLEY CROSSING DR STE 165 |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29414-5865 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386609931 | Laura Lee Kinney | Internal Medicine | 2270 Ashley Crossing Dr Ste 165, Charleston, SC 29414-5865 | 2006-04-18 |
| 1841853728 | Rachael E Wills | Nurse Practitioner | 2270 Ashley Crossing Dr Ste 165, Charleston, SC 29414-5865 | 2019-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902444508 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 3865 West Ashley Circle, Charleston, SC 29414 | 2019-12-13 |
| 1215440169 | Christine Michelle Delcioppo | Nurse Practitioner | 2085 Henry Tecklenburg Dr Fl 2or2, Charleston, SC 29414 | 2017-11-14 |
| 1871013508 | Carolyn Sorenson | Assistant Behavior Analyst | 2218 Hunter Creek Dr, Charleston, SC 29414 | 2017-06-23 |
| 1205387354 | Rachel Klatt | Physical Therapist | 2230 Ashley Crossing Dr., Charleston, SC 29414 | 2016-10-24 |
| 1295286912 | Mary M Butler | Physical Therapy Assistant | 2230 Ashley Crossing Drive, Charleston, SC 29414 | 2016-10-18 |
| 1295104982 | Charlene Barbot | Registered Nurse | 3741 Clover St, Charleston, SC 29414 | 2015-09-23 |
| 1720467525 | Sasha M. Perez | Family Medicine | 3030 Ashley Town Center Dr Ste 102a, Charleston, SC 29414 | 2015-05-26 |
| 1104226240 | Angela Mcinvale | Counselor | 3030 Ashley Town Center Dr., Bldg. B-203, Charleston, SC 29414 | 2014-08-26 |
| 1659790087 | Catherine Jefferson Vanderwerker | Physical Therapist | 3019 Saintsbury Cove Dr, Charleston, SC 29414 | 2014-04-14 |
| 1104266741 | Elizabeth A Burguieres | Psychiatry & Neurology | Scdmh- Charleston Telepsychiatry Office, 706 Orleans Rd, Charleston, SC 29414 | 2013-06-27 |
| Find all providers in zip 29414 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972128221 | John Fincher Gist Bobo | Internal Medicine | 169 Ashley Ave Rm 202muh, Charleston, SC 29425-8905 | 2020-06-12 |
| 1831746874 | Roper Saint Francis Physicians Network | Internal Medicine | 615 Wesley Dr Ste 120, Charleston, SC 29407-7206 | 2019-08-23 |
| 1104486463 | Matthew Bruner | Internal Medicine | 162 Ashley Ave Rm 202, Charleston, SC 29425-8907 | 2019-06-19 |
| 1366001760 | Rayphael Sebastian Hardy | Internal Medicine | 169 Ashley Avenue Room 202 Main Hospital Msc333, Charleston, SC 29425 | 2019-06-10 |
| 1427617950 | Emily Suzanne Nyers | Internal Medicine | 169 Ashley Ave., Room 202 Main Hospital, Msc 333, Charleston, SC 29425 | 2019-06-09 |
| 1225697931 | Shenia Lorraine Singleton | Internal Medicine | 706 Tahoe St, Charleston, SC 29407-6629 | 2019-06-07 |
| 1871152520 | Elena Vlachos | Internal Medicine | 169 Ashley Aveneue Room 202 Main Hospital, Charleston, SC 29425-0001 | 2019-06-06 |
| 1750877890 | Mona Ali Haj | Internal Medicine | 96 Jonathan Lucas St Rm 202, Charleston, SC 29425-8900 | 2018-07-02 |
| 1538654025 | Megan Kathleen Veglia | Internal Medicine | 135 Rutledge Ave Fl 8, Charleston, SC 29425-8905 | 2018-06-27 |
| 1457881559 | Milad Cesar El Hajj | Internal Medicine | 96 Jonathan Lucas St Ste 807, Charleston, SC 29425-8900 | 2017-06-13 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 29414 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.