1. Home
  2. Directory
  3. South Carolina
  4. Summerville
  5. Family Medicine
  6. NPI Profile

SEASIDE FAMILY MEDICINE, LLC
NPI 1043707557
Family Medicine in Summerville, SC

Active since April 19, 2018CLIA 42D2153532 · Waiver
1341 COLLEGE PARK RD # A, SUMMERVILLE, SC 29486(843) 400-0028(843) 790-8449 Get Directions Write a Review

NPPES record last updated: August 13, 2018. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 13, 2018, May 8, 2018, Apr 19, 2018 (3 updates tracked since 2018).

About Seaside Family Medicine, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SEASIDE FAMILY MEDICINE, LLC (NPI 1043707557) is a healthcare organization registered as a family medicine in Summerville, South Carolina and active in the NPI registry since April 2018. The organization holds a CLIA Waiver certificate valid through August 26, 2028 and lists Amanda E. Mcallister, Np, Owner, as its authorized official.

NPPES Registry Identity

NPI1043707557
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSEASIDE FAMILY MEDICINE, LLC
Location Address1341 COLLEGE PARK RD # ASummerville, SC 29486
Mailing Address1341 College Park Rd # ASummerville, SC 29486-8635 · (843) 400-0028 · Fax (843) 790-8449
Phone(843) 400-0028
Fax(843) 790-8449
Organization SubpartNo
Authorized OfficialAmanda E. McallisterNp, Owner · (843) 400-0028
Enumeration DateApril 19, 2018
Last NPPES UpdateAugust 13, 20183 updates tracked since enumeration
✔ NPI 1043707557 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
Also ListedNurse Practitioner · PediatricsTaxonomy 363LP0200X · License 18442 (SC)
1341 COLLEGE PARK RD # A, Summerville, SC 29486
Open in Google Maps ↗

Other Identifiers 1

MedicaidNP2488SC

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of South Carolina.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Seaside Family Medicine, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to Seaside Family Medicine, LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (7)

Amanda Mcallister, NP
Nurse Practitioner
NPI 1982037495
1341 COLLEGE PARK RD STE A
Summerville, SC 29486
(781) 413-5414
✔ PECOSSame address
Catherine Crosby, APRN
Nurse Practitioner
NPI 1316308794
1801 OLD TROLLEY RD STE 200
Summerville, SC 29485
(843) 781-0075
✔ PECOS✔ Accepts Medicare6.9 mi
Marcelaine Reneau, PHD
Nurse Practitioner
NPI 1841386364
109 BEE ST
Charleston, SC 29401
(843) 577-5011
✔ PECOS✔ Accepts Medicare20 mi
Gary Headden, M.D.
Internal Medicine
NPI 1720196777
171 ASHLEY AVE
Charleston, SC 29425
(843) 792-1414
✔ PECOS20 mi
Lee Ross, FNP-C
Nurse Practitioner
NPI 1982116331
526 NORTH ST
Bamberg, SC 29003
(803) 245-2433
✔ PECOS✔ Accepts Medicare44 mi
Jennifer Young, FNP-C
Nurse Practitioner
NPI 1437521556
400 RENAISSANCE CTR STE 2600
Detroit, MI 48243
(888) 731-8994
✔ PECOS660 mi
Desiree Ballesteros, NP
Nurse Practitioner
NPI 1013561182
125 130TH ST SE
Everett, WA 98208
(425) 224-8200
✔ PECOS2,407 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 42D2153532

Seaside Family Medicine, LLC · Summerville, SC
Active · expires Aug 26, 2028
CLIA Number42D2153532
Laboratory TypePhysician Office
Certificate Effective DateAugust 27, 2026
Certificate Expiration DateAugust 26, 2028
Laboratory DirectorMs. Amanda E. Mccalister
Laboratory Phone(843) 400-0028
Laboratory LocationSeaside Family Medicine, LLC1708 Old Trolley Road, Suite C, Summerville, SC 29485
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Seaside Family Medicine, LLC's NPI number?

The NPI number for Seaside Family Medicine, LLC is 1043707557. It was assigned to this organization in the NPPES registry on April 19, 2018.

Where is Seaside Family Medicine, LLC located?

Seaside Family Medicine, LLC is located at 1341 College Park Rd # A, Summerville, SC 29486. The listed phone number is (843) 400-0028.

What is Seaside Family Medicine, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Seaside Family Medicine, LLC enrolled in Medicare?

Yes. Seaside Family Medicine, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Seaside Family Medicine, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 2 Medicare specialties reassign their Medicare billing to Seaside Family Medicine, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (6) and Internal Medicine (1). Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Seaside Family Medicine, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 42D2153532) is associated with this NPI, valid through August 26, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Seaside Family Medicine, LLC accept?

Health plans from BlueCross BlueShield of South Carolina list Seaside Family Medicine, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Seaside Family Medicine, LLC was last updated on August 13, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.