Individual provider Active NPI

Hollen Alexa Davinsizer, PA-C

  • Physician Assistant
  • Mount Pleasant, SC
National Provider Identifier
1073237947
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4608 Issued in SC
Practice address
1150 Hungryneck Blvd Ste D
Mount Pleasant, SC 29464-3484
Phone
(843) 884-1876
NPI assigned
Oct 3, 2022
Last updated
Oct 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4608 SC Primary

Addresses

Primary practice location

1150 Hungryneck Blvd Ste D
Mount Pleasant, SC 29464-3484

Mailing address

210 Buckeye Dr
Harmony, PA 16037-8130
Phone (724) 816-5608

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
I20221103003397 SC Practitioner - Physician Assistant 5395112304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CpandlGroup PAC ID 6608289806, 5 clinicians

Practice addresses (Care Compare)

1150 Hungryneck Blvd
Suite D
Mount Pleasant, SC 29464-3484
Phone (843) 884-1876

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4608SCMDDentist

Organizations & group practices 1

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": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1073237947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 BUCKEYE DR",
            "city": "HARMONY",
            "state": "PA",
            "postal_code": "160378130",
            "telephone_number": "724-816-5608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 HUNGRYNECK BLVD STE D",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643484",
            "telephone_number": "843-884-1876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVINSIZER",
        "first_name": "HOLLEN",
        "middle_name": "ALEXA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-03",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

Verify at the official NPI Registry.