Individual provider Active NPI

Eugene Ancrum II, PA

  • Physician Assistant
  • North Charleston, SC
National Provider Identifier
1043694334
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2439 Issued in SC
Practice address
8720 Dorchester Rd
North Charleston, SC 29420-7303
Phone
(843) 789-1620
NPI assigned
Jul 16, 2015
Last updated
Apr 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2439 SC Primary
Medical Physician Assistant 363AM0700X 2439 SC
Medical Physician Assistant 363AM0700X NU

Addresses

Primary practice location

8720 Dorchester Rd
North Charleston, SC 29420-7303

Mailing address

8720 Dorchester Rd
North Charleston, SC 29420-7303
Phone (843) 789-1620

Other identifiers 1

IdentifierTypeStateIssuer
2431PAMedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160104000140 SC Practitioner - Physician Assistant 9830491208 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charleston Carenow Urgent Care LLCGroup PAC ID 3274893359, 72 clinicians

Practice addresses (Care Compare)

1675 N Main St
Summerville, SC 29486-7847
Phone (843) 285-2169

8720 Dorchester Rd
North Charleston, SC 29420-7303
Phone (843) 552-3629

8740 Rivers Ave
North Charleston, SC 29406-9211
Phone (843) 377-2406

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2439SCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Carenow Urgent Care, LLC CurrentSince May 16, 2026 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Jun 12, 2017 Accepting new patients
Medcare Urgent Care Center - Anderson LLC CurrentSince Oct 24, 2022 Accepting new patients
Bon Secours St Francis Xavier Hospital, Inc. CurrentSince Jul 2, 2018 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Jun 12, 2017 Accepting new patients
Bon Secours St. Francis Xavier Hospital, Inc. CurrentSince Jul 2, 2018 Accepting new patients

Locations

1115 Savannah Hwy
Charleston, SC 29407
Phone (843) 300-3355

1850 Sam Rittenberg Blvd
Ste B
Charleston, SC 29407
Phone (843) 576-5246

2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

8720 Dorchester Rd
North Charleston, SC 29420
Phone (843) 552-3629

8720 Dorchester Rd
Ste 1201
North Charleston, SC 29420
Phone (843) 552-3629

8901 University Blvd
North Charleston, SC 29406
Phone (843) 203-2245

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1437004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1043694334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8720 DORCHESTER RD",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294207303",
            "telephone_number": "843-789-1620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8720 DORCHESTER RD",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294207303",
            "telephone_number": "843-789-1620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANCRUM",
        "first_name": "EUGENE",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-16",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2439",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "2439",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2431PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

Verify at the official NPI Registry.