Individual provider Active NPI

Elisa Marie Brown, PA-C

  • Physician Assistant
  • Charleston, SC
National Provider Identifier
1174273056
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6062 Issued in SC
Practice address
2097 Henry Tecklenburg Dr Ste 316W
Charleston, SC 29414-5744
Phone
(843) 789-1800
Fax
(843) 606-8036
NPI assigned
Mar 24, 2022
Last updated
Aug 31, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 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 6062 SC Primary

Addresses

Primary practice location

2097 Henry Tecklenburg Dr Ste 316W
Charleston, SC 29414-5744

Mailing address

PO Box 751649
Charlotte, NC 28275-1649
Phone (888) 472-0043

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, 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

Enrollment IDStateProvider typePAC IDDetails
I20220427002080 TX Practitioner - Physician Assistant 1153718820 Reassigns benefits to 1 organization
I20260518001611 SC Practitioner - Physician Assistant 1153718820 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Baylor College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5133 Rivers Ave
North Charleston, SC 29406-6338
Phone (843) 720-8440

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6062SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Saint Francis Physicians Network Past Accepting new patients

Organizations & group practices 4

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": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1174273056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "888-472-0043",
            "fax_number": "843-724-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2097 HENRY TECKLENBURG DR STE 316W",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145744",
            "telephone_number": "843-789-1800",
            "fax_number": "843-606-8036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ELISA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "6062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.