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LEGACY INTERNAL MEDICINE LLC
NPI 1528345162
Internal Medicine in Mount Pleasant, SC

Active since November 10, 2011CLIA 42D2028725 · Waiver
550 LONG POINT RD STE 100, MOUNT PLEASANT, SC 29464(843) 606-9199(843) 718-2858 Get Directions Write a Review

NPPES record last updated: April 15, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Legacy Internal Medicine Llc NPPES

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

LEGACY INTERNAL MEDICINE LLC (NPI 1528345162) is a healthcare organization registered as an internal medicine in Mount Pleasant, South Carolina and active in the NPI registry since November 2011. The organization holds a CLIA Waiver certificate valid through August 22, 2027 and lists Tina M Botelho, Physician/owner, as its authorized official.

NPPES Registry Identity

NPI1528345162
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameLEGACY INTERNAL MEDICINE LLC
Location Address550 LONG POINT RD STE 100Mount Pleasant, SC 29464-8000
Mailing Address550 Long Point Rd Ste 100Mount Pleasant, SC 29464-8000 · (843) 606-9199 · Fax (843) 718-2858
Phone(843) 606-9199
Fax(843) 718-2858
Organization SubpartNo
Authorized OfficialTina M BotelhoPhysician/owner · (843) 606-9199
Enumeration DateNovember 10, 2011
Last NPPES UpdateApril 15, 2025
NPPES CertifiedApril 15, 2025
✔ NPI 1528345162 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.
550 LONG POINT RD STE 100, Mount Pleasant, SC 29464
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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 Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina.Insurance ›

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 42D2028725

Legacy Internal Medicine · Mount Pleasant, SC
Active · expires Aug 22, 2027
CLIA Number42D2028725
Laboratory TypePhysician Office
Certificate Effective DateAugust 23, 2025
Certificate Expiration DateAugust 22, 2027
Laboratory DirectorTina M. Botelho
Laboratory Phone(843) 606-9199
Laboratory LocationLegacy Internal Medicine550 Long Point Rd, Suite 100, Mount Pleasant, SC 29464
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 Legacy Internal Medicine LLC's NPI number?

The NPI number for Legacy Internal Medicine LLC is 1528345162. It was assigned to this organization in the NPPES registry on November 10, 2011.

Where is Legacy Internal Medicine LLC located?

Legacy Internal Medicine LLC is located at 550 Long Point Rd Ste 100, Mount Pleasant, SC 29464. The listed phone number is (843) 606-9199.

What is Legacy Internal Medicine LLC's specialty?

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

Does Legacy Internal Medicine LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 42D2028725) is associated with this NPI, valid through August 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Legacy Internal Medicine LLC accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina and BlueCross BlueShield of South Carolina list Legacy Internal 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 Legacy Internal Medicine LLC was last updated on April 15, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.