Individual provider Active NPI

Elizabeth Ashley Halicki, NP

  • Gerontology Nurse Practitioner
  • Charleston, SC
National Provider Identifier
1770129553
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
23514 Issued in SC
Practice address
776 Daniel Ellis Dr Ste 1B
Charleston, SC 29412-3095
Phone
(843) 795-0300
NPI assigned
Nov 26, 2019
Last updated
Oct 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 23514 SC Primary

Addresses

Primary practice location

776 Daniel Ellis Dr Ste 1B
Charleston, SC 29412-3095

Mailing address

PO Box 530062
Atlanta, GA 30353-0062
Phone (843) 792-6200

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
I20200224002915 SC Practitioner - Nurse Practitioner 0143657510 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

776 Daniel Ellis Dr
Suite 1B
Charleston, SC 29412-3095
Phone (843) 695-6071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol Current Accepting new patients
Palmetto Primary Care Physicians, LLC Current Accepting new patients
Palmetto Primary Care Physicians, LLC CurrentSince Sep 8, 2025 Accepting new patients
University Medical Associates CurrentSince Jan 18, 2020 Accepting new patients
Palmetto Primary Care Physicians, LLC CurrentSince Sep 8, 2025 Accepting new patients
University Medical Associates of the Medical University of South Carol Nurse Practitioner CurrentSince Jan 18, 2020 Accepting new patients
Palmetto Primary Care Physicians, LLC Past Accepting new patients

Locations

1401 Main St
Bonneau, SC 29431
Phone (843) 825-3404

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

776 Daniel Ellis Dr
Ste 1B
Charleston, SC 29412
Phone (843) 795-0300

96 Jonathan Lucas St
Ste 420
Charleston, SC 29425
Phone (843) 792-3072

2500 Elms Center Rd
North Charleston, SC 29406
Phone (763) 348-2075

Interoperability endpoints

  • Direct secure messaging: elizabeth.halicki@ppcp1.eclinicaldirectplus.com

Organizations & group practices 7

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": "1574726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1770129553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530062",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303530062",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "776 DANIEL ELLIS DR STE 1B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294123095",
            "telephone_number": "843-795-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALICKI",
        "first_name": "ELIZABETH",
        "middle_name": "ASHLEY",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-26",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "SC",
            "license": "23514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.