ANGEL OAK FAMILY MEDICINE LLC
NPI 1902083058
Clinic/Center - Rural Health in Johns Island, SC
About Angel Oak Family Medicine Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANGEL OAK FAMILY MEDICINE LLC (NPI 1902083058) is a healthcare organization registered as a rural health in Johns Island, South Carolina and active in the NPI registry since January 2008. The organization holds a CLIA Waiver certificate valid through January 8, 2028 and lists Jacqueline Leonara Baer, Provider, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Accepted 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)
Angel Oak Family Medicine Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Angel Oak Family Medicine LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 42D0995075
Angel Oak Family Medicine LLC · Johns Island, SCFrequently 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 Angel Oak Family Medicine LLC's NPI number?
The NPI number for Angel Oak Family Medicine LLC is 1902083058. It was assigned to this organization in the NPPES registry on January 30, 2008.
Where is Angel Oak Family Medicine LLC located?
Angel Oak Family Medicine LLC is located at 1816 Bohicket Rd Ste F, Johns Island, SC 29455. The listed phone number is (843) 559-1938.
What is Angel Oak Family Medicine LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.
Is Angel Oak Family Medicine LLC enrolled in Medicare?
Yes. Angel Oak Family Medicine LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Angel Oak Family Medicine LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Angel Oak 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Angel Oak Family Medicine LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 42D0995075) is associated with this NPI, valid through January 8, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Angel Oak Family Medicine LLC accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina, First Choice Next and Molina Healthcare and 1 other insurer list Angel Oak 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 Angel Oak Family Medicine LLC was last updated on December 6, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Angel Oak Family Medicine Llc · NPI 1902083058
Rural Health organization in Johns Island, South Carolina. Organization record, active in the CMS NPPES registry since January 30, 2008.
## Identity
- **NPI:** 1902083058 (Entity type: Organization)
- **Enumerated:** January 30, 2008
- **Primary specialty:** Clinic/Center - Rural Health · taxonomy 261QR1300X
- **Organization subpart:** No
- **Authorized official:** Jacqueline Baer, PROVIDER
## Practice location
- **Address:** 1816 BOHICKET RD STE F, Johns Island, SC 29455-3318
- **Phone:** (843) 559-1938
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 6, 2012
- **Other identifiers:** Medicare OSCAR/certification 428975 (SC)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1902083058) · Data from the CMS NPPES public registry.