1. Home
  2. Directory
  3. South Carolina
  4. Edisto Island
  5. Internal Medicine
  6. NPI Profile

EDISTO MEDICINE
NPI 1073476198
Internal Medicine in Edisto Island, SC

Active since December 05, 2025CLIA 42D2336462 · Waiver
134 JUNGLE RD, EDISTO ISLAND, SC 29438(843) 897-7757(843) 897-7877 Get Directions Write a Review

NPPES record last updated: December 5, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Edisto Medicine NPPES

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

EDISTO MEDICINE (NPI 1073476198) is a healthcare organization registered as an internal medicine in Edisto Island, South Carolina and active in the NPI registry since December 2025. The organization holds a CLIA Waiver certificate valid through January 4, 2028 and lists Kimberly Dawn Rakes-stephens, Md, as its authorized official.

NPPES Registry Identity

NPI1073476198
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameEDISTO MEDICINE
Location Address134 JUNGLE RDEdisto Island, SC 29438-3005
Mailing Address134 Jungle RdEdisto Island, SC 29438-3005 · (843) 897-7757 · Fax (843) 897-7877
Phone(843) 897-7757
Fax(843) 897-7877
Organization SubpartNo
Authorized OfficialKimberly Dawn Rakes-stephensMd · (843) 217-1695
Enumeration DateDecember 5, 2025
NPPES CertifiedDecember 5, 2025
✔ NPI 1073476198 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
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.
134 JUNGLE RD, Edisto Island, SC 29438
Open in Google Maps ↗

Other Names 1

Doing Business AsEdisto Medicine

Other Identifiers 1

Other17943SC · License

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.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)

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

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Edisto Medicine, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Kimberly Rakes-Stephens, M.D.
Internal Medicine
NPI 1457354888
134 JUNGLE RD
Edisto Island, SC 29438
(843) 897-7757
✔ PECOS✔ Accepts MedicareSame address
Jennifer Walker, APRN
Nurse Practitioner
NPI 1437411097
134 JUNGLE RD
Edisto Island, SC 29438
(843) 897-7757
✔ PECOS✔ Accepts MedicareSame address

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 42D2336462

Edisto Medicine · Edisto Island, SC
Active · expires Jan 4, 2028
CLIA Number42D2336462
Laboratory TypePhysician Office
Certificate Effective DateJanuary 5, 2026
Certificate Expiration DateJanuary 4, 2028
Laboratory DirectorKimberly D. Rakes-Stephens
Laboratory Phone(843) 897-7757
Laboratory LocationEdisto Medicine134 Jungle Road, Edisto Island, SC 29438
CLIA data matches this NPI record on: Address 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 Edisto Medicine's NPI number?

The NPI number for Edisto Medicine is 1073476198. It was assigned to this organization in the NPPES registry on December 5, 2025.

Where is Edisto Medicine located?

Edisto Medicine is located at 134 Jungle Rd, Edisto Island, SC 29438. The listed phone number is (843) 897-7757.

What is Edisto Medicine's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Edisto Medicine enrolled in Medicare?

Yes. Edisto Medicine is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Edisto Medicine?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Edisto Medicine, in Internal Medicine and Nurse Practitioner. 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. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Edisto Medicine hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 42D2336462) is associated with this NPI, valid through January 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Edisto Medicine accept?

Health plans from Molina Healthcare list Edisto Medicine 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 Edisto Medicine was last updated on December 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.