Individual provider Active NPI

Matthew Whitley, PA-C

  • Physician Assistant
  • Orangeburg, SC
National Provider Identifier
1689411761
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5864 Issued in SC
Practice address
1748 Saint Matthews Rd
Orangeburg, SC 29118-2441
Phone
(803) 536-0613
Fax
(803) 536-2876
NPI assigned
Jul 15, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5864 SC Primary

Addresses

Primary practice location

1748 Saint Matthews Rd
Orangeburg, SC 29118-2441

Mailing address

PO Box 749306
Atlanta, GA 30374-9306

Other practice location 1

151 Rutledge Ave Bldg A
Charleston, SC 29425-8903
Phone (828) 808-3708

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
I20251106000144 SC Practitioner - Physician Assistant 8325538572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Urgent Cares LLCGroup PAC ID 8628502598, 183 clinicians

Practice addresses (Care Compare)

1748 Saint Matthews Rd
Orangeburg, SC 29118-2441
Phone (803) 536-0613

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Urgent Cares LLC CurrentSince Aug 30, 2025 Accepting new patients

Locations

6167 Braided Mane Pass SW
Aiken, SC 29803
Phone (803) 502-1484

230 W Wade Hampton Blvd
Greer, SC 29650
Phone (864) 591-2261

1748 Saint Matthews Rd
Orangeburg, SC 29118
Phone (803) 536-0613

Organizations & group practices 1

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": "1721001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1689411761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749306",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1748 SAINT MATTHEWS RD",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291182441",
            "telephone_number": "803-536-0613",
            "fax_number": "803-536-2876"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "151 Rutledge Ave Bldg A",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294258903",
            "country_code": "US",
            "telephone_number": "828-808-3708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITLEY",
        "first_name": "MATTHEW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-15",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "5864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orangeburg, SC

Sources for this page

Verify at the official NPI Registry.