TIDEWATER HEALTH
NPI 1649773789
Clinic/Center - Primary Care in Mount Pleasant, SC

Active since March 15, 2018CLIA 42D2164254 · Waiver
1435 STUART ENGALS BLVD STE 101, MOUNT PLEASANT, SC 29464(843) 800-5686(843) 800-5656 Get Directions Write a Review

NPPES record last updated: May 1, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 1, 2019, Feb 20, 2019, Aug 28, 2018 and 3 more (6 updates tracked since 2018).

About Tidewater Health NPPES

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

TIDEWATER HEALTH (NPI 1649773789) is a healthcare organization registered as a primary care in Mount Pleasant, South Carolina and active in the NPI registry since March 2018. The organization holds a CLIA Waiver certificate valid through March 31, 2027 and lists David L Smith, President, as its authorized official.

NPPES Registry Identity

NPI1649773789
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameTIDEWATER HEALTH PC
Location Address1435 STUART ENGALS BLVD STE 101Mount Pleasant, SC 29464-7312
Mailing Address1435 Stuart Engals Blvd Ste 101Mount Pleasant, SC 29464-7312 · (843) 800-5686 · Fax (843) 800-5656
Fax(843) 800-5656
Organization SubpartNo
Authorized OfficialDavid L SmithPresident · (843) 800-5686
Enumeration DateMarch 15, 2018
Last NPPES UpdateMay 1, 20196 updates tracked since enumeration
NPI 1649773789 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
1435 STUART ENGALS BLVD STE 101, Mount Pleasant, SC 29464

Other Names 1

Doing Business AsTidewater Health

Accepted 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 42D2164254

Tidewater Health · Mount Pleasant, SC
Active · expires Mar 31, 2027
CLIA Number42D2164254
Laboratory TypePhysician Office
Certificate Effective DateApril 1, 2025
Certificate Expiration DateMarch 31, 2027
Laboratory DirectorDavid C. Smith
Laboratory Phone(843) 800-5686
Laboratory LocationTidewater Health1435 Stuart Engals Blvd Suite101, Mount Pleasant, SC 29464
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

Family Medicine
1435 STUART ENGALS BLVD STE 101
MOUNT PLEASANT, SC 29464

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 Tidewater Health PC's NPI number?

The NPI number for Tidewater Health PC is 1649773789. It was assigned to this organization in the NPPES registry on March 15, 2018. The provider is doing business as Tidewater Health.

Where is Tidewater Health PC located?

Tidewater Health PC is located at 1435 Stuart Engals Blvd Ste 101, Mount Pleasant, SC 29464. The listed phone number is (843) 800-5686.

What is Tidewater Health PC's specialty?

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

Does Tidewater Health PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 42D2164254) is associated with this NPI, valid through March 31, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Tidewater Health PC accept?

Health plans from BlueCross BlueShield of South Carolina list Tidewater Health PC 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 Tidewater Health PC was last updated on May 1, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.