NPIMap

Individual provider Active NPI

Brittany Whiteside Tucker, P.A.

  • Physician Assistant
  • Charleston, SC
National Provider Identifier
1124369194
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1904 Issued in SC
Practice address
316 Calhoun St
Charleston, SC 29401-1113
Phone
(843) 724-2010
Fax
(843) 724-2005
NPI assigned
Mar 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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 1904 SC Primary

Addresses

Primary practice location

316 Calhoun St
Charleston, SC 29401-1113

Mailing address

PO Box 601495
Charlotte, NC 28260-1495
Phone (843) 789-1620

Other identifiers 1

IdentifierTypeStateIssuer
1685PAMedicaidSC

Other names 1

  • Brittany D Whiteside Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, AL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130904000918 SC Practitioner - Physician Assistant 3577706985 Reassigns benefits to 4 organizations
I20211013002611 AL Practitioner - Physician Assistant 3577706985 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours St Francis Xavier Hospital, Inc. CurrentSince Sep 2, 2020 Accepting new patients
Bon Secours St. Francis Xavier Hospital, Inc. CurrentSince Sep 2, 2020 Accepting new patients
Roper St. Francis Mount Pleasant Hospital CurrentSince Jun 4, 2016 Accepting new patients
Roper Hospital Inc. CurrentSince Jun 4, 2016 Accepting new patients
Trinity Emergency Physicians LLC CurrentSince Apr 15, 2023 Accepting new patients
Pain Specialists of Charleston CurrentSince Jul 13, 2013 Accepting new patients
Roper St. Francis Mount Pleasant Hospital CurrentSince Jun 4, 2016 Accepting new patients
Pain Specialists of Charleston PA CurrentSince Jul 13, 2013 Accepting new patients
Roper Hospital Inc CurrentSince Jun 4, 2016 Accepting new patients

Locations

3690 Grandview Pkwy
Vestavia, AL 35243
Phone (205) 592-1000

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

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

3500 N Highway 17
Mt Pleasant, SC 29466
Phone (843) 606-7000

2695 Elms Plantation Blvd
Ste A
North Charleston, SC 29406
Phone (843) 818-1181

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1363305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1124369194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601495",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601495",
            "telephone_number": "843-789-1620",
            "fax_number": "843-724-2454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 CALHOUN ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294011113",
            "telephone_number": "843-724-2010",
            "fax_number": "843-724-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "BRITTANY",
        "middle_name": "WHITESIDE",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-15",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "1904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1685PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRITTANY",
            "last_name": "WHITESIDE",
            "middle_name": "D",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.