MEDICARE: CHARLESTON OT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225XP0200X	Pediatric Occupational Therapist
2	235Z00000X	Speech-Language Pathologist
3	225X00000X	Occupational Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144679655
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHARLESTON OT LLC

Provider Business Mailing Address
First Line	:	1563 SAM RITTENBERG BLVD
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29407-4248
Country	:	US
Telephone Number	:	843-277-2411
Fax Number	:	855-504-4089

Provider Business Practice Location Address
First Line	:	1563 SAM RITTENBERG BLVD
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29407-4248
Country	:	US
Telephone Number	:	843-277-2411
Fax Number	:	855-504-4089

Authorized Official
Title or Position	:	OWNER
Name	:	NICOLE SAWYER RAMSEY
Credential	:	MOT
Telephone Number	:	774-721-6252

Provider Enumeration Date	:	06/06/2016
Last Update Date	:	11/20/2025

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Directions to “CHARLESTON OT LLC ” Practice Location

Language	Start Address	Practice Location

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