NPIMap

Individual provider Active NPI

Emily Jordan Peacock, PA-C

  • Physician Assistant
  • Ladson, SC
National Provider Identifier
1164112389
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3601 Ladson Rd
Ladson, SC 29456-4304
Phone
(843) 285-2500
NPI assigned
May 10, 2023
Last updated
Jul 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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 NU Primary

Addresses

Primary practice location

3601 Ladson Rd
Ladson, SC 29456-4304

Mailing address

3601 Ladson Rd
Ladson, SC 29456-4304
Phone (843) 303-7244

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231101001133 SC Practitioner - Physician Assistant 1951757624 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of South Carolina School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Guild St
Suite 101
Summerville, SC 29486-3021
Phone (843) 792-1414

167 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

2000 1St Ave
Summerville, SC 29486-0408
Phone (843) 876-7930

3601 Ladson Rd
Suite 100
Ladson, SC 29456-4304
Phone (843) 285-2500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.02 of 100Reported as group
Quality
62.41
Promoting interoperability
99
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
81.85 of 100Reported as group
Quality
72.99
Promoting interoperability
100
Improvement activities
30
Cost
75.18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol CurrentSince Jul 1, 2024 Accepting new patients
University Medical Associates of the Medical University of South Carol Physician Assistant CurrentSince Jul 1, 2024 Accepting new patients

Locations

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

3601 Ladson Rd
Ste 100
Ladson, SC 29456
Phone (843) 285-2500

Organizations & group practices 3

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1164112389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 LADSON RD",
            "city": "LADSON",
            "state": "SC",
            "postal_code": "294564304",
            "telephone_number": "843-303-7244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 LADSON RD",
            "city": "LADSON",
            "state": "SC",
            "postal_code": "294564304",
            "telephone_number": "843-285-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "EMILY",
        "middle_name": "JORDAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-10",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ladson, SC

Sources for this page

Verify at the official NPI Registry.