LOWCOUNTRY WELLNESS CENTER LLC
NPI 1639604929
Clinic/Center - Primary Care in Charleston, SC

Q: What is Lowcountry Wellness Center LLC's NPI number?

The NPI number for Lowcountry Wellness Center LLC is 1639604929. It was assigned to this organization in the NPPES registry on April 25, 2017.

Q: What is Lowcountry Wellness Center LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Active since April 25, 2017CLIA 42D2157875 · Waiver

1565 SAM RITTENBERG BLVD STE 201, CHARLESTON, SC 29407(843) 793-1353(843) 818-4172 Get Directions Write a Review

NPPES record last updated: July 28, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Sep 28, 2020, Jul 21, 2020 and 4 more (7 updates tracked since 2017).

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About Lowcountry Wellness Center Llc NPPES

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

LOWCOUNTRY WELLNESS CENTER LLC (NPI 1639604929) is a healthcare organization registered as a primary care in Charleston, South Carolina and active in the NPI registry since April 2017. The organization holds a CLIA Waiver certificate valid through November 14, 2026 and lists Penelope Lynn Vachon, Member, as its authorized official.

NPPES Registry Identity

NPI1639604929

Entity TypeOrganization

Primary Taxonomy261QP2300X

Legal Business NameLOWCOUNTRY WELLNESS CENTER LLC

Location Address1565 SAM RITTENBERG BLVD STE 201Charleston, SC 29407-4138

Mailing Address1565 Sam Rittenberg Blvd Ste 201Charleston, SC 29407-4138 · (843) 793-1353 · Fax (843) 818-4172

Phone(843) 793-1353

Fax(843) 818-4172

Organization SubpartNo

Authorized OfficialPenelope Lynn VachonMember · (843) 793-1353

Enumeration DateApril 25, 2017

Last NPPES UpdateJuly 28, 20257 updates tracked since enumeration

NPPES CertifiedJuly 28, 2025

✔ NPI 1639604929 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities

Taxonomy Code261QP2300X

1565 SAM RITTENBERG BLVD STE 201, Charleston, SC 29407

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Other Identifiers 1

Other1639604929SC · Npi

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 42D2157875

Lowcountry Wellness Center, LLC · Charleston, SC

Active · expires Nov 14, 2026

CLIA Number42D2157875

Laboratory TypePhysician Office

Certificate Effective DateNovember 15, 2024

Certificate Expiration DateNovember 14, 2026

Laboratory DirectorPenelope L. Vachon

Laboratory Phone(843) 793-1353

Laboratory LocationLowcountry Wellness Center, LLC1565 Sam Rittenberg Blvd, Ste 201, Charleston, SC 29407

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. MELISA SUZANNE COFFIN APRN

Nurse Practitioner (Family)