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Export Provider Record NPI 1205002888
Covenant Family Allergy, Pc
Organization Subpart: NO
Active
NPI Number1205002888
NPI TypeNPI-2 Organization
SpecialtyAllergy & Immunology
Provider Details
NPI1205002888
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2008-05-05
Last Updated2013-04-18
Authorized OfficialMatthew Clark
Physician/Owner
Phone: 8034418648
Mailing Address616 Edgefield Rd, Suite 180
North Augusta, SC 29841-1938
United States
Phone: (803) 279-7666 | Fax: (803) 279-0708
📍 View Map
Primary Practice Address616 Edgefield Rd, Suite 180
North Augusta, SC 29841-1938
United States
Phone: (803) 279-7666 | Fax: (803) 279-0708
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)SC28227State Medical License
Other (non-Medicare)GA57156State Medical License
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes207K00000X – Allergy & ImmunologySC28227
Export Provider Record NPI 1205002888
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About NPI 1205002888

Covenant Family Allergy, Pc is an organization registered in the CMS NPPES NPI Registry with NPI number 1205002888. The primary specialty listed is Allergy & Immunology. The organization is located in North Augusta, SC. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2008-05-05. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1205002888?

NPI 1205002888 belongs to Covenant Family Allergy, Pc, a Allergy & Immunology in North Augusta, SC. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1205002888 active?

The current status of NPI 1205002888 in the NPPES registry is Active. The record was last updated on 2013-04-18.

What specialty is NPI 1205002888?

NPI 1205002888 is classified under the taxonomy Allergy & Immunology. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1205002888?

You can verify NPI 1205002888 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1205002888?

The primary practice address on file for NPI 1205002888 is 616 Edgefield Rd, North Augusta, SC 29841-1938. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1205002888 issued?

NPI 1205002888 was first issued (enumerated) on 2008-05-05. The NPPES record was last updated on 2013-04-18.

Practice Location Map

Covenant Family Allergy, Pc is located at 616 Edgefield Rd, North Augusta, SC. Use the map below to find directions or verify the practice location.

📍 616 Edgefield Rd, North Augusta, SC 29841-1938  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Covenant Family Allergy, Pc. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1205002888. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Allergy & Immunology28227SC
Data Verified from CMS NPPES Last synced: 2026-08-30 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162