Individual provider Active NPI

Ukeisha Renee Frazier, NP

  • Gerontology Nurse Practitioner
  • Charleston, SC
National Provider Identifier
1477135341
Registry record updated Mar 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN.24901 Issued in SC
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

Updated by the provider on Mar 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220609002593 SC Practitioner - Nurse Practitioner 5597143149

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.24901SCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Bradley B Bailey MD and Roger B Schechter MD Inc CurrentSince Feb 1, 2025 Accepting new patients
Scmwc Inc CurrentSince Feb 1, 2025 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.

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

Verify at the official NPI Registry.