NPIMap

Individual provider Active NPI

Jennifer Davis Preston, P.A.

  • Medical Physician Assistant
  • Charleston, SC
National Provider Identifier
1326280124
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1417 Issued in SC
Practice address
171 Ashley Ave
Charleston, SC 29425-5441
Phone
(843) 792-1414
NPI assigned
Mar 25, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1417 SC Primary

Addresses

Primary practice location

171 Ashley Ave
Charleston, SC 29425-5441

Mailing address

PO Box 751461
Charlotte, NC 28275-1461
Phone (843) 792-6200

Other practice location 1

955 Ribaut Rd
Beaufort, SC 29902-5441
Phone (843) 532-6472

Other practice location 2

316 Calhoun St
Charleston, SC 29401-1113
Phone (843) 724-2010

Other identifiers 1

IdentifierTypeStateIssuer
1683PAMedicaidSC

Other names 1

  • Jennifer Davis Fralix Former name

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
I20090827000258 SC Practitioner - Physician Assistant 2264587294 Reassigns benefits to 5 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Roper St. Francis Mount Pleasant Hospital CurrentSince Oct 14, 2018 Accepting new patients
Roper Hospital Inc. CurrentSince Oct 14, 2018 Accepting new patients
Musc Community Physicians CurrentSince Dec 1, 2023 Accepting new patients
Musc Community Physicians CurrentSince Dec 1, 2023 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Dec 17, 2017 Accepting new patients
Hilton Head Emergency Physicians, Inc. CurrentSince Jun 9, 2009 Accepting new patients
Roper Hospital Inc CurrentSince Oct 14, 2018 Accepting new patients
Roper St. Francis Mount Pleasant Hospital CurrentSince Oct 14, 2018 Accepting new patients
Regional Medical Center of Orangeburg and Calhoun Counties Past Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

169 Ashley Ave
Charleston, SC 29425
Phone (843) 792-3072

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

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

25 Hospital Ctr
Hilton Head Island, SC 29926
Phone (843) 682-2345

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

Interoperability endpoints

  • Direct secure messaging: jennifer.preston.p1@direct.scdc.nextgenshare.com

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1237939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1326280124",
    "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": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294255441",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "955 Ribaut Rd",
            "address_purpose": "LOCATION",
            "city": "Beaufort",
            "state": "SC",
            "postal_code": "299025441",
            "country_code": "US",
            "telephone_number": "843-532-6472",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "316 Calhoun St",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294011113",
            "country_code": "US",
            "telephone_number": "843-724-2010",
            "fax_number": "843-724-2005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRESTON",
        "first_name": "JENNIFER",
        "middle_name": "DAVIS",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-25",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "1417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1683PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "FRALIX",
            "middle_name": "DAVIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.