Individual provider Active NPI

Lisa Davis, DNP, APRN, FNP-C

  • Family Nurse Practitioner
  • Fairfax, SC
National Provider Identifier
1710608377
Registry record updated Feb 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26318 Issued in SC
Practice address
333 Revolutionary TRL
Fairfax, SC 29827-7109
Phone
(803) 632-2533
NPI assigned
Sep 12, 2022
Last updated
Feb 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26318 SC Primary

Addresses

Primary practice location

333 Revolutionary TRL
Fairfax, SC 29827-7109

Mailing address

1008 Lake Murray Blvd
Irmo, SC 29063-2821

Other practice location 1

1008 Lake Murray Blvd
Irmo, SC 29063-2821
Phone (866) 389-2727

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
I20221121001734 SC Practitioner - Nurse Practitioner 1557739620 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic South Carolina LLCGroup PAC ID 8527126861, 113 clinicians
Low Country Health Care System IncGroup PAC ID 4284530940, shared by 10 NPIs, 33 clinicians

Practice addresses (Care Compare)

1008 Lake Murray Blvd
Irmo, SC 29063-2821
Phone (866) 389-2727

333 Revolutionary TRL
Fairfax, SC 29827-7109
Phone (803) 632-2533

86 Wren St
Barnwell, SC 29812-1529
Phone (803) 259-5762

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26318SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Low Country Health Care System, Inc Current Accepting new patients
Low Country Health Care System, Inc. CurrentSince Feb 6, 2023 Accepting new patients
Low Country Health Care System, Inc. Current Accepting new patients
Low Country Health Care System, Inc CurrentSince Feb 6, 2023 Accepting new patients
Low Country Health Care System, Inc Past Accepting new patients
Low Country Health Care System, Inc Past Accepting new patients

Locations

86 Wren St
Barnwell, SC 29812
Phone (803) 259-5762

333 Revolutionary Trl
Fairfax, SC 29827
Phone (803) 632-2533

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771027200000",
    "number": "1710608377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 LAKE MURRAY BLVD",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 REVOLUTIONARY TRL",
            "city": "FAIRFAX",
            "state": "SC",
            "postal_code": "298277109",
            "telephone_number": "803-632-2533"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1008 Lake Murray Blvd",
            "address_purpose": "LOCATION",
            "city": "Irmo",
            "state": "SC",
            "postal_code": "290632821",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-12",
        "last_updated": "2026-02-14",
        "certification_date": "2026-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "26318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, SC

Sources for this page

Verify at the official NPI Registry.