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ANGEL OAK FAMILY MEDICINE LLC
NPI 1902083058
Clinic/Center - Rural Health in Johns Island, SC

Active since January 30, 2008CLIA 42D0995075 · Waiver
1816 BOHICKET RD STE F, JOHNS ISLAND, SC 29455(843) 559-1938 Get Directions Write a Review

NPPES record last updated: December 6, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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

NPI1902083058
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameANGEL OAK FAMILY MEDICINE LLC
Location Address1816 BOHICKET RD STE FJohns Island, SC 29455-3318
Mailing AddressPo Box 336Johns Island, SC 29457-0336 · (843) 559-1938
Phone(843) 559-1938
Organization SubpartNo
Authorized OfficialJacqueline Leonara BaerProvider · (843) 559-1938
Enumeration DateJanuary 30, 2008
Last NPPES UpdateDecember 6, 2012
✔ NPI 1902083058 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
License✔ Licensed in SC · RHC153
1816 BOHICKET RD STE F, Johns Island, SC 29455
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Other Identifiers 1

Medicare OSCAR/certification428975SC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, First Choice Next and more.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 42D0995075

Angel Oak Family Medicine LLC · Johns Island, SC
Active · expires Jan 8, 2028
CLIA Number42D0995075
Laboratory TypeCommunity Clinic
Certificate Effective DateJanuary 9, 2026
Certificate Expiration DateJanuary 8, 2028
Laboratory DirectorJacqueline L. Mendes
Laboratory Phone(843) 559-1938
Laboratory LocationAngel Oak Family Medicine LLC1816 Bohicket Rd, Suite F PO Box 336, Johns Island, SC 29455
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 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.

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 from Absolute Total Care, Ambetter of North Carolina, First Choice Next, Molina Healthcare and UnitedHealthcare 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 with the weekly NPPES data releases published by CMS.