Liza Rachel Boaz, MSN, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

22392 Issued in SC

Practice address

406 Brighton Park Blvd Ste 101
Summerville, SC 29486-3056

Phone

(854) 287-3560

Fax

(854) 287-3561

NPI assigned

May 5, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Lisa Rachel Bergrin Former name

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife, Master of Science - Nursing

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: liza.bergrin.1@29808.direct.athenahealth.com

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.

• Epicentre, LLC

  • Obstetrics & Gynecology Physician
  • Charleston, SC
  • NPI 1194363580

  SC

  Medicare reassignment NPD
• University Medical Associates of the Medical University of South Carol

  • Multi-Specialty Clinic/Center
  • Charleston, SC
  • NPI 1043241110

  SC

  Medicare reassignment NPD
• University Medical Associates of the Medical University of South Carol

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1982678496
  NPD

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

{
    "created_epoch": "1493942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1689100968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2048 CHARLIE HALL BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145830",
            "telephone_number": "843-804-6010",
            "fax_number": "843-804-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 BRIGHTON PARK BLVD STE 101",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294863056",
            "telephone_number": "854-287-3560",
            "fax_number": "854-287-3561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2048 Charlie Hall Blvd",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294145830",
            "country_code": "US",
            "telephone_number": "843-792-1414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOAZ",
        "first_name": "LIZA",
        "middle_name": "RACHEL",
        "credential": "MSN, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-05",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "SC",
            "license": "22392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "BERGRIN",
            "middle_name": "RACHEL",
            "credential": "CNM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Summerville, SC
• Advanced Practice Midwife in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.