Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1497052666 Individual Practitioner Male Practitioner

Ted Tristan Nussbaum , RPH

Pharmacist • Moncks Corner, SC

Professional Overview & Biography Verified Profile Summary

Ted Nussbaum, RPH is a registered healthcare professional specializing in Pharmacist in Moncks Corner, SC. Practice services are available at 1008 OLD HIGHWAY 52 STE G under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1008 Old Highway 52 Ste G

Moncks Corner, SC 294613011

Telephone 8438994700
Fax 8438994702
Associated Practice Facility / Clinic
🏢 Berkeley Home Pharmacy Llc Facility NPI 1508223645

Specialty Benchmarks & Practice Insights

Comparative analytics for Pharmacist in Moncks Corner, SC

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
35 Specialists

Practicing in Moncks Corner, SC (5339 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-06-10
Pharmacist Primary Specialty

NUCC Taxonomy Code: 183500000X

State License SC 11560

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
NPI 1023905759

Doctor of Pharmacy (Pharm.D.)

NPI 1720745979

Doctor of Pharmacy (Pharm.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
📍
Updated Business Mailing Address June 10, 2025

Registered at 1008 OLD HIGHWAY 52 STE G, MONCKS CORNER, SC 294613011 (Tel: 8438308640)

📍
Updated Business Mailing Address September 30, 2024

Registered at 1509 WATERSIDE BLVD, MONCKS CORNER, SC 294617172 (Tel: 8438308640)

📍
Updated Practice Location March 15, 2021

Registered at 1008 OLD HIGHWAY 52 STE G, MONCKS CORNER, SC 294613011 (Tel: 8438994700)

📍
Updated Business Mailing Address March 15, 2021

Registered at 1404 BRITISH DR, MONCKS CORNER, SC 294617128 (Tel: 8438308640)

NPI Profile Active February 23, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location February 23, 2011

Registered at 395 N HIGHWAY 52, MONCKS CORNER, SC 294613919 (Tel: 8438996601)

📍
Updated Business Mailing Address February 23, 2011

Registered at 395 N HIGHWAY 52, MONCKS CORNER, SC 294613919 (Tel: 8438996601)

👤
Provider Name / Credentials Updated February 23, 2011

Recorded as TED NUSSBAUM, RPH

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 23, 2011

Pharmacist (License #11560 in SC)

🟢
Initial NPI Registration & Enumeration February 23, 2011

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1497052666
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 23, 2011
Last Update: June 10, 2025
Sole Proprietor: No

Mailing Address

1008 Old Highway 52 Ste G

Moncks Corner, SC 294613011

Phone: 8438308640

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.