Kelli S Daughtry

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

00010-10521 Issued in NC

Practice address

1014 Huger Dr
Georgetown, SC 29440-3322

Phone

(843) 520-8780

Fax

(843) 652-8399

NPI assigned

Aug 16, 2019

Last updated

Nov 13, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 5

Medicare fee-for-service enrollment

Enrolled in NC, SC2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Georgetown Physician Associates, LLCGroup PAC ID 2365697398, 221 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tidelands Waccamaw Community Hospital Hospital, Murrells Inlet, SC, CCN 420098

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kdaughtry@goshenmedical.cloudcraftdirect.com
• Direct secure messaging: kdaughtry509731@direct.musc.edu

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.

• Georgetown Physician Associates, LLC

  dba Tidelands Health Family Medicine

  • Family Medicine Physician
  • Murrells Inlet, SC
  • NPI 1235475930
  Medicare reassignment Care Compare group
• Goshen Medical Center, Incorporated

  dba Goshen Medical Center - Duplin

  • Federally Qualified Health Center (FQHC)
  • Kenansville, NC
  • NPI 1962124974
  Medicare reassignment
• Star Medical Clinic PLLC

  • General Practice Physician
  • Jacksonville, NC
  • NPI 1033565007
  Medicare reassignment
• Tinsley Surgical, PA

  • Vascular Surgery Physician
  • Wilmington, NC
  • NPI 1407326291
  Medicare reassignment
• Georgetown Physician Associates LLC

  dba Tidelands Health Group

  • Family Medicine Physician
  • Georgetown, SC
  • NPI 1881410587
  NPD
• Goshen Medical Center Incorporated

  • Federally Qualified Health Center (FQHC)
  • Faison, NC
  • NPI 1154378933
  NPD
• Goshen Medical Center Incorporated

  dba GMC Pharmacy at Rockingham

  • Federally Qualified Health Center (FQHC)
  • Rockingham, NC
  • NPI 1457181323
  NPD
• Goshen Medical Center Incorporated

  dba Goshen Medical Center - Chadbourn

  • Federally Qualified Health Center (FQHC)
  • Chadbourn, NC
  • NPI 1598143836
  NPD
• Georgetown Physician Services, LLC

  dba Waccamaw Family Medicine

  • Family Medicine Physician
  • Pawley's Island, SC
  • NPI 1962691402
  NPD (past)
• Gardner-Webb University

  • Voluntary or Charitable Agency
  • Boiling Springs, NC
  • NPI 1720265903
  NPD (past)
• Gardner-Webb University

  • Voluntary or Charitable Agency
  • Boiling Springs, NC
  • NPI 1881870038
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Waccamaw Community Hospital

  dba Tidelands Waccamaw Community Hospital

  • General Acute Care Hospital
  • Murrells Inlet, SC
  • NPI 1972503910
  Care Compare affiliation

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

{
    "created_epoch": "1565913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1154977916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421718",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294424203",
            "telephone_number": "843-527-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 HUGER DR",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294403322",
            "telephone_number": "843-520-8780",
            "fax_number": "843-652-8399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 Crow Ln Ste 303B",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295771663",
            "country_code": "US",
            "telephone_number": "843-520-8780",
            "fax_number": "843-652-8399",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4040 Highway 17 Unit 104",
            "address_purpose": "LOCATION",
            "city": "Murrells Inlet",
            "state": "SC",
            "postal_code": "295765098",
            "country_code": "US",
            "telephone_number": "843-652-8390",
            "fax_number": "843-652-8399",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5115 Oleander Dr",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284037018",
            "country_code": "US",
            "telephone_number": "910-362-1011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4040 Highway 17 Unit 104",
            "address_purpose": "LOCATION",
            "city": "Murrells Inlet",
            "state": "SC",
            "postal_code": "295765098",
            "country_code": "US",
            "telephone_number": "843-652-8390",
            "fax_number": "843-652-8399",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Crow Ln Ste 303B",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295771663",
            "country_code": "US",
            "telephone_number": "843-520-8780",
            "fax_number": "843-652-8399",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1014 Huger DR",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "SC",
            "postal_code": "294403322",
            "country_code": "US",
            "telephone_number": "843-520-8780",
            "fax_number": "843-652-8399",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "606 Black River Rd Ste 301",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "SC",
            "postal_code": "294403304",
            "country_code": "US",
            "telephone_number": "843-652-8390",
            "fax_number": "843-652-8399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAUGHTRY",
        "first_name": "KELLI",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-16",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "00010-10521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdaughtry509731@direct.musc.edu",
            "affiliation": "Y",
            "affiliationName": "Georgetown Physician Associates, LLC",
            "address_1": "4040 Highway 17",
            "address_2": "Suite 202",
            "city": "Murrells Inlet",
            "state": "SC",
            "country_code": "US",
            "postal_code": "29576",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdaughtry509731@direct.musc.edu",
            "affiliation": "Y",
            "affiliationName": "Georgetown Physician Associates, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4040 Highway 17 Unit 104",
            "city": "Murrells Inlet",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295765098",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdaughtry509731@direct.musc.edu",
            "affiliation": "Y",
            "affiliationName": "Georgetown Physician Associates, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1014 Huger DR",
            "city": "Georgetown",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294403322",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdaughtry509731@direct.musc.edu",
            "affiliation": "Y",
            "affiliationName": "Georgetown Physician Associates, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "606 Black River Rd Ste 301",
            "city": "Georgetown",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294403304",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdaughtry509731@direct.musc.edu",
            "affiliation": "Y",
            "affiliationName": "Georgetown Physician Associates, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2200 Crow Ln Ste 303B",
            "city": "Myrtle Beach",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295771663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Crystal L. Franklin, OD, PA
• Melissa Cumbee
• David Leo Cyr, RPH
• Otto I Czechner, DO
• Janese Daniels, BS
• Gerald Allen Davidson, BA, BSN, MSHS, CRNA
• John Michael Davis, PA-C
• Carol Davison, RN, BSN
• Robert Edwin Deane, DMD
• Lillianne Marie Lewis Debnam, MD, MPH

• Physician Assistant in Georgetown, SC
• Providers in Georgetown, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.