Individual provider Active NPI

Porscha Rush, NP

  • Adult Health Nurse Practitioner
  • Galivants Ferry, SC
National Provider Identifier
1427696475
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
23506 Issued in SC
Practice address
1040 Frye Rd
Galivants Ferry, SC 29544-8018
Phone
(843) 360-3225
NPI assigned
Dec 19, 2019
Last updated
Dec 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 23506 SC Primary

Addresses

Primary practice location

1040 Frye Rd
Galivants Ferry, SC 29544-8018

Mailing address

1040 Frye Rd
Galivants Ferry, SC 29544-8018
Phone (843) 360-3225

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
I20200902000778 SC Practitioner - Nurse Practitioner 7416374657 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32506SCMDFamily Medicine Physician
23506SCMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midlands Neurology & Pain Assoc, P.a CurrentSince Nov 8, 2021 Accepting new patients
Providence House Calls LLC CurrentSince Nov 17, 2020 Accepting new patients
Midlands Neurology & Pain Assoc, P.a Past Accepting new patients

Locations

2601 Millwood Ave
Columbia, SC 29205
Phone (803) 788-0038

634 Fairview Rd
Simpsonville, SC 29680
Phone (843) 851-3126

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.

NPI Registry JSON

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

{
    "created_epoch": "1576713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1427696475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 FRYE RD",
            "city": "GALIVANTS FERRY",
            "state": "SC",
            "postal_code": "295448018",
            "telephone_number": "843-360-3225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 FRYE RD",
            "city": "GALIVANTS FERRY",
            "state": "SC",
            "postal_code": "295448018",
            "telephone_number": "843-360-3225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSH",
        "first_name": "PORSCHA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-19",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "SC",
            "license": "23506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galivants Ferry, SC

Sources for this page

Verify at the official NPI Registry.