Active NPI
Kortni Michelle Davis, PA-C
- Physician Assistant
- Charleston, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 96 Jonathan Lucas St
Charleston, SC 29425-8900 - Phone
- (843) 792-1414
- NPI assigned
- Feb 14, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
96 Jonathan Lucas St
Charleston, SC 29425-8900
Mailing address
6607 Buttercup Dr
Cheyenne, WY 82009-5718
Phone (307) 286-6894
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL, SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1 Poston Rd
Charleston, SC 29407-3428
PO Box
Charlotte, NC 28275-1461
Hospital & facility affiliations
- Musc Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6138 | SC | MD | Orientation and Mobility Training Rehabilitation Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Medical Associates of the Medical University of South Carol | Physician Assistant | Current | Accepting new patients |
| University Medical Associates of the Medical University of South Carol | Current | Accepting new patients | |
| University Medical Associates of the Medical University of South Carol | Current | Accepting new patients |
Locations
171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123
96 Jonathan Lucas St
Charleston, SC 29425
Phone (843) 792-3072
Organizations & group practices 4
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.
-
- Multi-Specialty Clinic/Center
- Charleston, SC
- NPI 1043241110
-
- Emergency Medicine Physician
- Huntsville, AL
- NPI 1659366649
-
- Anesthesiology Physician
- Charleston, SC
- NPI 1104843713
-
- Family Medicine Physician
- Charleston, SC
- NPI 1982678496
Physician Assistant
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Charleston, SC
- NPI 1073605879
-
- Rehabilitation Hospital
- Orangeburg, SC
- NPI 1154020147
-
- General Acute Care Hospital
- Charleston, SC
- NPI 1659435840
-
- Psychiatric Hospital
- Orangeburg, SC
- NPI 1669171740
-
- General Acute Care Hospital
- Orangeburg, SC
- NPI 1710683354
-
- General Acute Care Hospital
- Orangeburg, SC
- NPI 1770280299
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771545600000",
"number": "1639934193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6607 BUTTERCUP DR",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820095718",
"telephone_number": "307-286-6894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "96 JONATHAN LUCAS ST",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294258900",
"telephone_number": "843-792-1414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "KORTNI",
"middle_name": "MICHELLE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-14",
"last_updated": "2026-02-20",
"certification_date": "2026-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"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 Feb 20, 2026; 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.