NPIMap

Individual provider Active NPI

Rachel Davis, AGNP-C

  • Gerontology Nurse Practitioner
  • Charleston, SC
National Provider Identifier
1285431304
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
30016 Issued in SC
Practice address
171 Ashley Ave
Charleston, SC 29425-0100
Phone
(843) 792-1414
NPI assigned
Feb 26, 2025
Last updated
Apr 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 30016 SC Primary

Addresses

Primary practice location

171 Ashley Ave
Charleston, SC 29425-0100

Mailing address

PO Box 751461
Charlotte, NC 28275-1461
Phone (843) 792-1414

Other identifiers 1

IdentifierTypeStateIssuer
NN1093MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.musc.edu Health Information Exchange (HIE)

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
I20250514003367 SC Practitioner - Nurse Practitioner 1951829852 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Medical University of South Carolina College of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

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

9313 Medical Plaza Dr
Suite 202
North Charleston, SC 29406-9176
Phone (843) 695-6071

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30016SCMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Primary Care Physicians, LLC Current Accepting new patients
Palmetto Primary Care Physicians, LLC CurrentSince Mar 17, 2025 Accepting new patients
Palmetto Primary Care Physicians, LLC CurrentSince Mar 17, 2025 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Feb 15, 2026 Accepting new patients
Palmetto Primary Care Physicians, LLC Past Accepting new patients
Palmetto Primary Care Physicians, LLC Past Accepting new patients

Locations

1401 Main St
Bonneau, SC 29431
Phone (843) 825-3404

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

776 Daniel Ellis Dr
Ste 1B
Charleston, SC 29412
Phone (843) 795-0300

2500 Elms Center Rd
North Charleston, SC 29406
Phone (763) 348-2075

9313 Medical Plaza Dr
Ste 202
North Charleston, SC 29406
Phone (843) 572-1200

Interoperability endpoints

  • Direct secure messaging: rachel.davis@ppcp1.eclinicaldirectplus.com

Organizations & group practices 7

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 8

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": "1740528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1285431304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461",
            "telephone_number": "843-792-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294250100",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "RACHEL",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-26",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "SC",
            "license": "30016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NN1093",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "171 Ashley Ave",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294250100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.