Active NPI
Ukeisha Renee Frazier, NP
- Gerontology Nurse Practitioner
- Charleston, SC
National Provider Identifier
1477135341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- APRN.24901
- Practice address
- 1064 Gardner Rd Ste 302
Charleston, SC 29407-5746 - Phone
- (854) 444-2838
- Fax
- (854) 444-2839
- NPI assigned
- Apr 21, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | APRN.24901 | SC | |
| Gerontology Nurse Practitioner | 363LG0600X | APRN.24901 | SC | Primary |
Addresses
Primary practice location
1064 Gardner Rd Ste 302
Charleston, SC 29407-5746
Mailing address
1064 Gardner Rd Ste 302
Charleston, SC 29407-5746
Phone (854) 444-2838
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220609002593 | SC | Practitioner - Nurse Practitioner | 5597143149 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN.24901 | SC | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bradley B Bailey MD and Roger B Schechter MD Inc | Current | Accepting new patients | |
| Scmwc Inc | Current | Accepting new patients |
Locations
10089 Willow Creek Rd
Ste 200
San Diego, CA 92131
Phone (858) 621-1514
1117 48th Ave N
Ste 124
Myrtle Beach, SC 29577
Phone (619) 289-9356
Organizations & group practices 2
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.
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- Myrtle Beach, SC
- NPI 1356187132
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- Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
- San Diego, CA
- NPI 1831349315
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677801600000",
"number": "1477135341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1064 GARDNER RD STE 302",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294075746",
"telephone_number": "854-444-2838",
"fax_number": "854-444-2839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1064 GARDNER RD STE 302",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294075746",
"telephone_number": "854-444-2838",
"fax_number": "854-444-2839"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRAZIER",
"first_name": "UKEISHA",
"middle_name": "RENEE",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-21",
"last_updated": "2023-03-03",
"certification_date": "2023-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "SC",
"license": "APRN.24901",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "SC",
"license": "APRN.24901",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.