Individual provider Active NPI

Brittney Lynn Fitzgerald, PA-C

  • Physician Assistant
  • Charleston, SC
National Provider Identifier
1467123299
Registry record updated Oct 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4118 Issued in SC
Practice address
9228 Medical Plaza Dr
Charleston, SC 29406-9125
Phone
(843) 574-5693
NPI assigned
Sep 22, 2021
Last updated
Oct 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4118 SC Primary
Surgical Physician Assistant 363AS0400X 4118 SC

Addresses

Primary practice location

9228 Medical Plaza Dr
Charleston, SC 29406-9125

Mailing address

9228 Medical Plaza Dr
Charleston, SC 29406-9125
Phone (843) 574-5693

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
I20211027002332 SC Practitioner - Physician Assistant 8123416997 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Savannah Multispecialty Associates LLCGroup PAC ID 3678836558, 129 clinicians

Practice addresses (Care Compare)

25 Hospital Ctr Blvd
Hilton Head, SC 29926-2738
Phone (843) 681-6122

9228 Medical Plaza Dr
Charleston, SC 29406-9125
Phone (843) 574-5693

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4118SCMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Family Care, Inc CurrentSince Nov 10, 2021 Accepting new patients
Musc Community Physicians CurrentSince Jan 30, 2022 Accepting new patients
Carolina Family Care, Inc CurrentSince Nov 10, 2021 Accepting new patients
Musc Community Physicians CurrentSince Jan 30, 2022 Accepting new patients

Locations

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

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

1341 Old Georgetown Rd
Ste C
Mt Pleasant, SC 29464
Phone (843) 884-2175

Organizations & group practices 5

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 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": "1632268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1467123299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9228 MEDICAL PLAZA DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294069125",
            "telephone_number": "843-574-5693",
            "fax_number": "843-764-4512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9228 MEDICAL PLAZA DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294069125",
            "telephone_number": "843-574-5693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "BRITTNEY",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-22",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4118",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SC",
            "license": "4118",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.