Individual provider Active NPI

Shiquan Christopher, FNP

  • Nurse Practitioner
  • Charleston, SC
National Provider Identifier
1114624384
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26718 Issued in SC
Practice address
2048 Charlie Hall Blvd
Charleston, SC 29414-5830
Phone
(843) 804-6010
NPI assigned
Feb 8, 2023
Last updated
Feb 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26718 SC Primary

Addresses

Primary practice location

2048 Charlie Hall Blvd
Charleston, SC 29414-5830

Mailing address

9608 Pebble Creek Blvd
Summerville, SC 29485-8946
Phone (915) 449-1114

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
I20250407003795 SC Practitioner - Nurse Practitioner 2365966777 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26718SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Epicentre, LLC CurrentSince Dec 29, 2024 Accepting new patients

Locations

2048 Charlie Hall Blvd
Charleston, SC 29414
Phone (843) 763-5104

Interoperability endpoints

  • Direct secure messaging: shiquan.christopher.1@29808.direct.athenahealth.com

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": "1675814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1114624384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9608 PEBBLE CREEK BLVD",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858946",
            "telephone_number": "915-449-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2048 CHARLIE HALL BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145830",
            "telephone_number": "843-804-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTOPHER",
        "first_name": "SHIQUAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-08",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "26718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.