Individual provider Active NPI

Amanda W Peebles, FNP-C

  • Women's Health Nurse Practitioner
  • Summerville, SC
National Provider Identifier
1396220034
Registry record updated Mar 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
21838 Issued in SC
Practice address
406 Brighton Park Blvd Ste 101
Summerville, SC 29486-3056
Phone
(854) 287-3560
Fax
(854) 287-3561
NPI assigned
Sep 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 21838 SC Primary

Addresses

Primary practice location

406 Brighton Park Blvd Ste 101
Summerville, SC 29486-3056

Mailing address

880 Island Park Dr Unit 230
Daniel Island, SC 29492-2902
Phone (843) 380-9330

Other practice location 1

4278 Ladson Rd.
Summerville, SC 29485
Phone (843) 402-5283

Other practice location 2

1711 Clements Ferry Rd Unit 112
Charleston, SC 29492-8717
Phone (843) 606-7893

Other identifiers 1

IdentifierTypeStateIssuer
NP5557MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20181213002529 SC Practitioner - Nurse Practitioner 2961747241 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4278 Ladson Rd
Ladson, SC 29456-5452
Phone (843) 203-2240

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21838SCMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Saint Francis Physicians Network CurrentSince Nov 12, 2018 Accepting new patients
Roper Saint Francis Physicians Network Current Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Nov 12, 2018 Accepting new patients
East Cooper Physician Group LLC CurrentSince Feb 4, 2026 Accepting new patients
East Cooper Physician Group LLC CurrentSince Feb 4, 2026 Accepting new patients
Roper Saint Francis Physicians Network Past Accepting new patients
East Cooper Physician Group LLC Past Accepting new patients

Locations

1711 Clements Ferry Rd
Unit 112
Charleston, SC 29492
Phone (843) 606-7893

880 Island Park Dr
Unit 230
Daniel Island, SC 29492
Phone (843) 380-9330

3575 Maybank Hwy
Ste A
Johns Island, SC 29455
Phone (843) 402-1870

8536 Palmetto Commerce Pkwy
Ste 401
Ladson, SC 29456
Phone (843) 203-2260

4278 Ladson Rd
Ladson, SC 29456
Phone (843) 203-2240

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

Interoperability endpoints

  • Direct secure messaging: apeebles1236004@direct.bsmhealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1538092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773878400000",
    "number": "1396220034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 ISLAND PARK DR UNIT 230",
            "city": "DANIEL ISLAND",
            "state": "SC",
            "postal_code": "294922902",
            "telephone_number": "843-380-9330",
            "fax_number": "843-380-8212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 BRIGHTON PARK BLVD STE 101",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294863056",
            "telephone_number": "854-287-3560",
            "fax_number": "854-287-3561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4278 Ladson Rd.",
            "address_purpose": "LOCATION",
            "city": "Summerville",
            "state": "SC",
            "postal_code": "29485",
            "country_code": "US",
            "telephone_number": "843-402-5283",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1711 Clements Ferry Rd Unit 112",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294928717",
            "country_code": "US",
            "telephone_number": "843-606-7893",
            "fax_number": "843-402-3456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEEBLES",
        "first_name": "AMANDA",
        "middle_name": "W",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-28",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "SC",
            "license": "21838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP5557",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.