Kelsie Chandler Requa, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

2863 N Highway 17
Mount Pleasant, SC 29466-8962

Phone

(843) 572-5990

NPI assigned

Sep 4, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Eastern Virginia Medical School, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Charleston Carenow Urgent Care LLCGroup PAC ID 3274893359, 72 clinicians

Medcare Express - North Charleston LLCGroup PAC ID 7618074899, 69 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Medcare Express - North Charleston LLC

  dba Medcare Urgent Care

  • Urgent Care Clinic/Center
  • Charleston, SC
  • NPI 1457579617
  Medicare reassignment Care Compare group NPD
• Charleston Carenow Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Goose Creek, SC
  • NPI 1093248288
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536019200000",
    "number": "1619459849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 ALWYN BLVD",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294854000",
            "telephone_number": "843-412-2053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2863 N HIGHWAY 17",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294668962",
            "telephone_number": "843-572-5990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1115 Savannah Hwy",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294077805",
            "country_code": "US",
            "telephone_number": "843-572-5990",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8740 Rivers Ave",
            "address_purpose": "LOCATION",
            "city": "North Charleston",
            "state": "SC",
            "postal_code": "294069211",
            "country_code": "US",
            "telephone_number": "843-572-5990",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1675 N Main St",
            "address_purpose": "LOCATION",
            "city": "Summerville",
            "state": "SC",
            "postal_code": "294867847",
            "country_code": "US",
            "telephone_number": "843-572-5990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REQUA",
        "first_name": "KELSIE",
        "middle_name": "CHANDLER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-04",
        "last_updated": "2018-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reliant Medical Transport
• Renew Holistic Therapy and Coaching
• Sarah Grace Lindsey Renner, OTR/L
• Cassidy Bates Rentz, PHARM.D., RPH
• Rebecca Lindley Repaire, PA-C
• Return to Sport Physical Therapy
• Christian Fernando Reusche, M.D.
• Revive Chiropractic
• Alyssa Revuelta, PH.D.
• Dustin Gregory Rexroad, PHARMD

• Physician Assistant in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.