Individual provider Active NPI

Kristen Lee Overcash, PA

  • Physician Assistant
  • Charleston, SC
National Provider Identifier
1104148352
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
A912 Issued in SC
Practice address
1818 Remount Rd
Charleston, SC 29406-3239
Phone
(843) 766-6308
NPI assigned
Feb 15, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X A912 SC Primary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X A912 SC

Addresses

Primary practice location

1818 Remount Rd
Charleston, SC 29406-3239

Mailing address

1818 Remount Rd
Charleston, SC 29406-3239
Phone (843) 766-6308

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241203004634 SC Practitioner - Physician Assistant 0840726659 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A912SCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Musc Affiliate Physicians Single Specialty CurrentSince Dec 1, 2024 Accepting new patients
University Medical Associates Past Accepting new patients

Locations

1871 Savage Rd
Charleston, SC 29407
Phone (843) 766-6308

1818 Remount Rd
Charleston, SC 29406
Phone (843) 744-6971

105 Springhall Dr
Goose Creek, SC 29445
Phone (843) 766-6308

145 E Poinsett St
Greer, SC 29651
Phone 86460356003222

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1266192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1104148352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 REMOUNT RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294063239",
            "telephone_number": "843-766-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 REMOUNT RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294063239",
            "telephone_number": "843-766-6308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERCASH",
        "first_name": "KRISTEN",
        "middle_name": "LEE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-15",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "A912",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "A912",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.