The Ryan White Wellness Center - Medicare Primary Care in Charleston, SC

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The Ryan White Wellness Center is a medicare enrolled primary clinic (Internal Medicine - Infectious Disease) in Charleston, South Carolina. The current practice location for The Ryan White Wellness Center is 1481 Tobias Gadson Blvd, Suite 1, Charleston, South Carolina. For appointments, you can reach them via phone at (843) 402-3093. The mailing address for The Ryan White Wellness Center is Po Box 751649, Charlotte, North Carolina and phone number is (888) 472-0043.

The Ryan White Wellness Center is licensed to practice in South Carolina (license number ). The clinic also participates in the medicare program and its NPI number is 1104150739. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (843) 402-3093.

Contact Information

The Ryan White Wellness Center
1481 Tobias Gadson Blvd
Suite 1
Charleston
SC 29407-4794
(843) 402-3093
(843) 402-3094

Map and Direction


Primary Care Clinic Profile

Full NameThe Ryan White Wellness Center
SpecialityInternal Medicine
Location1481 Tobias Gadson Blvd, Charleston, South Carolina
Authorized Official Name and PositionWilliam Anthony Jackson (CEO)
Authorized Official Contact8437242954
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
The Ryan White Wellness Center
Po Box 751649
Charlotte
NC 28275-1649

Ph: (888) 472-0043		The Ryan White Wellness Center
1481 Tobias Gadson Blvd
Suite 1
Charleston
SC 29407-4794

Ph: (843) 402-3093

NPI Details:

NPI Number1104150739
Provider Enumeration Date09/30/2009
Last Update Date03/17/2024

Medicare PECOS Information:

Medicare PECOS PAC ID8426958919
Medicare Enrollment IDO20041228000500

Medical Identifiers

Medical identifiers for The Ryan White Wellness Center such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1104150739NPI-NPPES
083OtherSCBCBS SC AND BLUECHOICE SUFIX
GP5274MedicaidSC
088/093OtherSCTRICARE SUFFIX

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine (South Carolina)Secondary
207RI0200XInternal Medicine - Infectious Disease (South Carolina)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. The Ryan White Wellness Center acts as a billing entity for following providers:
Provider NameJohn M Ernst
Provider TypePractitioner - Hand Surgery
Provider IdentifiersNPI Number: 1619902905
PECOS PAC ID: 0244126720
Enrollment ID: I20040223000700
Provider NameJames J Carswell
Provider TypePractitioner - Critical Care (intensivists)
Provider IdentifiersNPI Number: 1720038805
PECOS PAC ID: 1557353893
Enrollment ID: I20040330000809
Provider NameBryan Henry Frain
Provider TypePractitioner - Cardiac Electrophysiology
Provider IdentifiersNPI Number: 1053377507
PECOS PAC ID: 3870570575
Enrollment ID: I20040701000101
Provider NameBrett Matthew Baker
Provider TypePractitioner - Cardiac Electrophysiology
Provider IdentifiersNPI Number: 1861458853
PECOS PAC ID: 9739166588
Enrollment ID: I20040701000119
Provider NameSarbabi Masindet
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1457464471
PECOS PAC ID: 2668431636
Enrollment ID: I20041006000007
Provider NameLance Lee Davis
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1003864521
PECOS PAC ID: 1557327905
Enrollment ID: I20041207000783
Provider NameJeffrey S Rieder
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1255397519
PECOS PAC ID: 7315915105
Enrollment ID: I20050310000742
Provider NameGeorge W Douglass
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1972538361
PECOS PAC ID: 9739133885
Enrollment ID: I20050310000902
Provider NameDonald E Saunders
Provider TypePractitioner - Interventional Cardiology
Provider IdentifiersNPI Number: 1861485088
PECOS PAC ID: 2163476268
Enrollment ID: I20050311000098
Provider NameScott Latimer Woodfield
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1568455723
PECOS PAC ID: 6901850007
Enrollment ID: I20050311000158
Provider NameKenneth H Hanger
Provider TypePractitioner - Interventional Cardiology
Provider IdentifiersNPI Number: 1992798235
PECOS PAC ID: 1850350778
Enrollment ID: I20050311000215
Provider NameWilliam B Ellison
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1356307318
PECOS PAC ID: 1557315579
Enrollment ID: I20050311000299
Provider NameLars Hokan Runquist
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1821054537
PECOS PAC ID: 7416901434
Enrollment ID: I20050311000328
Provider NameRobert A Pringle
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1124011424
PECOS PAC ID: 6800840836
Enrollment ID: I20050311000394
Provider NameGregory B Miller
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1770688764
PECOS PAC ID: 8325095334
Enrollment ID: I20050401000491
Provider NameWilliam J Grossman
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1023068897
PECOS PAC ID: 5597754101
Enrollment ID: I20050405001213
Provider NameBarbara P Hildreth
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1043275357
PECOS PAC ID: 4183668361
Enrollment ID: I20050617000885
Provider NameTheresa W Dryden
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1164408233
PECOS PAC ID: 2961491766
Enrollment ID: I20070208000152
Provider NameGraham C Scott
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1265481303
PECOS PAC ID: 2860596608
Enrollment ID: I20070426000040
Provider NameHamid R Bahadori
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1861571887
PECOS PAC ID: 4587765219
Enrollment ID: I20070725000596
Provider NameMatthew B O'steen
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1346285087
PECOS PAC ID: 0446263644
Enrollment ID: I20070808000257
Provider NameTroy A Bunting
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1558588962
PECOS PAC ID: 5597859215
Enrollment ID: I20070925000551
Provider NameToby Lynn Fugate
Provider TypePractitioner - Infectious Disease
Provider IdentifiersNPI Number: 1295870186
PECOS PAC ID: 6709853948
Enrollment ID: I20071108000548
Provider NameNancey Trevanian Tsai
Provider TypePractitioner - Physical Medicine And Rehabilitation
Provider IdentifiersNPI Number: 1205938040
PECOS PAC ID: 3779581244
Enrollment ID: I20071227000600
Provider NameScott D Ross
Provider TypePractitioner - Cardiac Surgery
Provider IdentifiersNPI Number: 1164413563
PECOS PAC ID: 9830124411
Enrollment ID: I20080102000014
Provider NameByron N Bailey
Provider TypePractitioner - Neurosurgery
Provider IdentifiersNPI Number: 1508804857
PECOS PAC ID: 6204917040
Enrollment ID: I20080117000429
Provider NameDowse Rustin
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1720070758
PECOS PAC ID: 3971577180
Enrollment ID: I20080702000709
Provider NameRobert G Quattlebaum
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1083704175
PECOS PAC ID: 3577639095
Enrollment ID: I20080908000343
Provider NameRoy W King
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1861447443
PECOS PAC ID: 1850390147
Enrollment ID: I20081119000755
Provider NameJason E Gunn
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1386760080
PECOS PAC ID: 7810045770
Enrollment ID: I20090501000447
Provider NameJames S Hawk
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1629293212
PECOS PAC ID: 8729131347
Enrollment ID: I20090729000885
Provider NameJennifer L Lewey
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1275860066
PECOS PAC ID: 1254468762
Enrollment ID: I20100414000697
Provider NameJohn Albert Mitchell
Provider TypePractitioner - Critical Care (intensivists)
Provider IdentifiersNPI Number: 1205886124
PECOS PAC ID: 6204993496
Enrollment ID: I20100615000461
Provider NameCynthia Heldrich
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1841247707
PECOS PAC ID: 4688705882
Enrollment ID: I20100702000371
Provider NameWilliam T Dawson
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1548210982
PECOS PAC ID: 2769549955
Enrollment ID: I20100924000435
Provider NameSteve E Herndon
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1861516668
PECOS PAC ID: 4688790421
Enrollment ID: I20100929000619
Provider NameJason Huet
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1841415155
PECOS PAC ID: 5294920062
Enrollment ID: I20101108000309
Provider NameJames L Bumgartner
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1477522845
PECOS PAC ID: 7416131032
Enrollment ID: I20110406000390
Provider NameCharles Jervey
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1801865365
PECOS PAC ID: 5799751921
Enrollment ID: I20110510000676
Provider NameSherry Z Ikalowych
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1366419624
PECOS PAC ID: 2365468915
Enrollment ID: I20120112000871
Provider NameJames T Reed
Provider TypePractitioner - Anesthesiology
Provider IdentifiersNPI Number: 1578609699
PECOS PAC ID: 3678641958
Enrollment ID: I20120208000023
Provider NameLauren Dubose Neese
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1427320068
PECOS PAC ID: 6002075538
Enrollment ID: I20120301000935
Provider NameJessica Michelle Chepa
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1629327713
PECOS PAC ID: 4587814140
Enrollment ID: I20121017000628
Provider NameCorynne A Boyer
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1912138983
PECOS PAC ID: 1153477070
Enrollment ID: I20121101000445
Provider NameMary K Logan
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1235576810
PECOS PAC ID: 9436392628
Enrollment ID: I20130909000433
Provider NameDeborah E Still
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1568788867
PECOS PAC ID: 2163666934
Enrollment ID: I20130917000413
Provider NameCandace Marie Nogues
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1396023230
PECOS PAC ID: 5597990812
Enrollment ID: I20131022001979
Provider NameTodd J Metz
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1588092662
PECOS PAC ID: 0244461606
Enrollment ID: I20140327001598
Provider NamePamela L Eliason
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1346453065
PECOS PAC ID: 4688806565
Enrollment ID: I20140408000305
Provider NameKatherine A Minnick
Provider TypePractitioner - Infectious Disease
Provider IdentifiersNPI Number: 1649276502
PECOS PAC ID: 3375775844
Enrollment ID: I20140415002131
Provider NameSandra S Munaco
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1225448723
PECOS PAC ID: 0840414983
Enrollment ID: I20140612000102
Provider NameVishal Abiraj
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1356652283
PECOS PAC ID: 8820239783
Enrollment ID: I20140814000873
Provider NameStephanie A James
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1982043717
PECOS PAC ID: 9234350497
Enrollment ID: I20141031002244
Provider NameJames Willis Fitzpatrick
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1760475859
PECOS PAC ID: 3577522663
Enrollment ID: I20141208001640
Provider NameKayla C Hanks
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1861895393
PECOS PAC ID: 2466776331
Enrollment ID: I20150123001967
Provider NameMonique Kaur Sandhu
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1306043823
PECOS PAC ID: 6709103385
Enrollment ID: I20150318002467
Provider NameMinh K Tran
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1346477494
PECOS PAC ID: 7618280603
Enrollment ID: I20150720003104
Provider NameDavid J Powell
Provider TypePractitioner - Physical Medicine And Rehabilitation
Provider IdentifiersNPI Number: 1043539406
PECOS PAC ID: 5294975496
Enrollment ID: I20150906000000
Provider NameSandra S Jones
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1023484946
PECOS PAC ID: 6901109214
Enrollment ID: I20160120002100
Provider NameNicholas Kevin Batchelor
Provider TypePractitioner - Critical Care (intensivists)
Provider IdentifiersNPI Number: 1831266956
PECOS PAC ID: 5597996942
Enrollment ID: I20160518001262
Provider NameWilliam Dana Largen
Provider TypePractitioner - Infectious Disease
Provider IdentifiersNPI Number: 1336435205
PECOS PAC ID: 0840411740
Enrollment ID: I20160602000980
Provider NameShari D Hulbert
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1235114455
PECOS PAC ID: 7517251697
Enrollment ID: I20160812000265
Provider NameRomina Ilic
Provider TypePractitioner - Anesthesiology
Provider IdentifiersNPI Number: 1619143898
PECOS PAC ID: 6305096967
Enrollment ID: I20170612000047
Provider NameMuhammad A Rashad
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1083843304
PECOS PAC ID: 5991010217
Enrollment ID: I20170822000234
Provider NameMoshe Mark Douglas Wexler
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1801858865
PECOS PAC ID: 2062794373
Enrollment ID: I20180320000000
Provider NameMary Elizabeth Hanley
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1285678433
PECOS PAC ID: 4284710542
Enrollment ID: I20180613002140
Provider NameSelena O. Anderson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1346737673
PECOS PAC ID: 8426303843
Enrollment ID: I20180626000831
Provider NameEunice Luz Guzman
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1043508708
PECOS PAC ID: 0244540979
Enrollment ID: I20180629002108
Provider NamePatrick Michael Looser
Provider TypePractitioner - Interventional Cardiology
Provider IdentifiersNPI Number: 1508165291
PECOS PAC ID: 2163779190
Enrollment ID: I20180723002445
Provider NameMichael E Field
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1033192802
PECOS PAC ID: 7113818170
Enrollment ID: I20180911000661
Provider NameCraig Anthony Schuring
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1447698360
PECOS PAC ID: 4981847464
Enrollment ID: I20190612002339
Provider NameCraig Anthony Schuring
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1447698360
PECOS PAC ID: 4981847464
Enrollment ID: I20190612003780
Provider NameAdrianna Elyzabeth Matusiak
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1518525393
PECOS PAC ID: 1557690294
Enrollment ID: I20190905003298
Provider NameKathryn Marie Aimar
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1720625783
PECOS PAC ID: 6709211964
Enrollment ID: I20200115002651
Provider NameChelsey A D Massey
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1932747748
PECOS PAC ID: 5597190595
Enrollment ID: I20200122000871
Provider NameJason L Foster
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1356973820
PECOS PAC ID: 3476982026
Enrollment ID: I20200401003167
Provider NameLauren E Doyle
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1710519939
PECOS PAC ID: 7012346166
Enrollment ID: I20200410002039
Provider NameLayne Alan Madden
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1346635612
PECOS PAC ID: 3173826070
Enrollment ID: I20200727002814
Provider NameKimberly Michelle Richardson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1336741560
PECOS PAC ID: 9931510740
Enrollment ID: I20201201000182
Provider NameSierra Katie Burgan
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1902495005
PECOS PAC ID: 7113331554
Enrollment ID: I20210127000532
Provider NameJayne M Donovan
Provider TypePractitioner - Physical Medicine And Rehabilitation
Provider IdentifiersNPI Number: 1407172794
PECOS PAC ID: 6305003740
Enrollment ID: I20210324002494
Provider NameMichael D Moxley
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1437147758
PECOS PAC ID: 9931116662
Enrollment ID: I20210604002048
Provider NameBlase Anthony Carabello
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1720092562
PECOS PAC ID: 9537336441
Enrollment ID: I20211207000360
Provider NameHeather Nicole Fabel
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1275298945
PECOS PAC ID: 9830580158
Enrollment ID: I20211221002395
Provider NameEmily Jeanne Culpepper
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1548854466
PECOS PAC ID: 2860884285
Enrollment ID: I20220115000192
Provider NameAlison Marie Bondell
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1013551332
PECOS PAC ID: 1850787482
Enrollment ID: I20220408000111
Provider NameHannah Mulliken Whitesides
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1376280198
PECOS PAC ID: 7810372141
Enrollment ID: I20220922000431
Provider NameDonald Frederick Bruner
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1114641289
PECOS PAC ID: 1052773819
Enrollment ID: I20230811000327
Provider NameStephen Harden
Provider TypePractitioner - Anesthesiology
Provider IdentifiersNPI Number: 1043623135
PECOS PAC ID: 3274883780
Enrollment ID: I20230817003852
Provider NameRobert Wallace Williams Biederman
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1912907734
PECOS PAC ID: 4284728189
Enrollment ID: I20240227003147

Reviews and Comments


Internal Medicine in Charleston, SC

Palmetto Primary Care Physicians, Llc
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Phone: 843-990-5866    Fax: 843-868-8041
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Phone: 843-792-6200    
Harold R Nicolette, Do, Pa
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Medicare: Medicare Enrolled
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Medicare: Not Enrolled in Medicare
Practice Location: 60 Barre St, Charleston, SC 29401
Phone: 901-292-7077    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.