NPIMap

Individual provider Active NPI

Angela Kelly Peterson, PA-C

  • Physician Assistant
  • North Charleston, SC
National Provider Identifier
1861721391
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
642 Issued in SC
Practice address
5880 Rivers Avenue
North Charleston, SC 29406
Phone
(843) 572-5990
Fax
(843) 552-4121
NPI assigned
Dec 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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 642 SC
Physician Assistant 363A00000X 642 SC Primary

Addresses

Primary practice location

5880 Rivers Avenue
North Charleston, SC 29406

Mailing address

5880 Rivers Ave
North Charleston, SC 29406-6053
Phone (843) 572-5990

Other practice location 1

354 Folly Rd Ste 5
Charleston, SC 29412
Phone (843) 225-2374

Other identifiers 1

IdentifierTypeStateIssuer
1805PAMedicaidSC

Other names 1

  • Angela Kelly Steele Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100301000079 SC Practitioner - Physician Assistant 1850436031 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical University of South Carolina College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Medical of SC LLCGroup PAC ID 0042550386, 6 clinicians

Practice addresses (Care Compare)

354 Folly Rd
Suite 5
Charleston, SC 29412-2594
Phone (843) 225-2374

5880 Rivers Ave
North Charleston, SC 29406-6053
Phone (843) 225-2374

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Roper St. Francis Mount Pleasant Hospital CurrentSince Dec 31, 2013 Accepting new patients
Roper Hospital Inc. CurrentSince Dec 31, 2013 Accepting new patients
Roper Hospital Inc CurrentSince Dec 31, 2013 Accepting new patients
Medcare Express - North Charleston LLC CurrentSince Dec 11, 2018 Accepting new patients
Nason Medical Center IV, LLC Past Accepting new patients
Cox Surgical LLC Past Accepting new patients
Nason Medical Center V, LLC Past Accepting new patients

Locations

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

3500 N Highway 17
Mt Pleasant, SC 29466
Phone (843) 606-7000

8720 Dorchester Rd
North Charleston, SC 29420
Phone (843) 552-3629

8740 Rivers Ave
North Charleston, SC 29406
Phone (843) 337-2406

Interoperability endpoints

  • Direct secure messaging: angela.peterson@148186305331204.direct.elationemr.com

Organizations & group practices 10

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1260489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1861721391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5880 RIVERS AVE",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294066053",
            "telephone_number": "843-572-5990",
            "fax_number": "843-552-4121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5880 RIVERS AVENUE",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "29406",
            "telephone_number": "843-572-5990",
            "fax_number": "843-552-4121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "354 FOLLY RD STE 5",
            "address_purpose": "LOCATION",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29412",
            "country_code": "US",
            "telephone_number": "843-225-2374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ANGELA",
        "middle_name": "KELLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-11",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "642",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1805PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "STEELE",
            "middle_name": "KELLY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in North Charleston, SC

Sources for this page

Verify at the official NPI Registry.