Individual provider Active NPI

Megan Oliver Sumner, PA

  • Physician Assistant
  • Charleston, SC
National Provider Identifier
1720414733
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1964 Issued in SC
Practice address
743 Folly Rd
Charleston, SC 29412-3432
Phone
(843) 762-2360
NPI assigned
Sep 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1964 SC
Physician Assistant 363A00000X 1964 SC Primary

Addresses

Primary practice location

743 Folly Rd
Charleston, SC 29412-3432

Mailing address

PO Box 749306
Atlanta, GA 30374-9306

Other identifiers 1

IdentifierTypeStateIssuer
1804PAMedicaidSC

Other names 1

  • Megan Elizabeth Oliver Former name

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
I20140327000489 SC Practitioner - Physician Assistant 5890926224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
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)

6167 Braided Mane Pass SW
Aiken, SC 29803-7839
Phone (803) 648-1464

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1964SCMDGeneral Practice Dentistry

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": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1720414733",
    "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": "743 FOLLY RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294123432",
            "telephone_number": "843-762-2360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMNER",
        "first_name": "MEGAN",
        "middle_name": "OLIVER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-23",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "1964",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "1964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1804PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "OLIVER",
            "middle_name": "ELIZABETH",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.