Magnolia Functional Medicine, LLC
NPI 1952196826ActiveOrganization· General Practice· Charleston, SC
General Practice in Charleston, South Carolina, registered in NPPES in April 2025. The authorized official on file is Jessica Green, Practice Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1952196826 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 11, 2025 |
| Last updated in NPPES | May 15, 2026 |
| Certified by provider | May 15, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| General Practice Primary | 208D00000X | — | — |
| Naturopath | 175F00000X | — | — |
| Internal Medicine, Endocrinology, Diabetes & Metabolism | 207RE0101X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (SC) |
|---|
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