NPIMap

Individual provider Active NPI

Penny Fanning, FNP

  • Nurse Practitioner
  • North Charleston, SC
National Provider Identifier
1912566365
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
22420 Issued in SC
Practice address
2910 Tricom St Ste 100
North Charleston, SC 29406-9351
Phone
(843) 572-9211
Fax
(843) 572-0457
NPI assigned
Jun 10, 2019
Last updated
Oct 1, 2025By the provider in NPPES
Sex
Female
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
Nurse Practitioner 363L00000X 22420 SC Primary

Addresses

Primary practice location

2910 Tricom St Ste 100
North Charleston, SC 29406-9351

Mailing address

PO Box 751874
Charlotte, NC 28275-1874
Phone (843) 402-5200

Other identifiers 1

IdentifierTypeStateIssuer
NP6107MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address penny.fanningrn@comcast.net

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
I20190918002693 SC Practitioner - Nurse Practitioner 7911237995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2910 Tricom St
N Charleston, SC 29406-9350
Phone (843) 572-9211

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours St Francis Xavier Hospital, Inc. CurrentSince Nov 6, 2022 Accepting new patients
Bon Secours St Francis Xavier Hospital, Inc. Current Accepting new patients
Bon Secours St. Francis Xavier Hospital, Inc. CurrentSince Nov 6, 2022 Accepting new patients

Locations

125 Doughty St
Ste 500
Charleston, SC 29403
Phone (843) 577-2276

2085 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 577-6957

2085 Henry Tecklenburg Dr
Fl 2
Charleston, SC 29414
Phone (843) 577-6957

2910 Tricom St
North Charleston, SC 29406
Phone (843) 572-9211

2910 Tricom St
Ste 100
North Charleston, SC 29406
Phone (843) 572-9211

Interoperability endpoints

  • Direct secure messaging: pfanning1252649@direct.bsmhealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1912566365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751874",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751874",
            "telephone_number": "843-402-5200",
            "fax_number": "843-402-5296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 TRICOM ST STE 100",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069351",
            "telephone_number": "843-572-9211",
            "fax_number": "843-572-0457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANNING",
        "first_name": "PENNY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-10",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "22420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP6107",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "penny.fanningrn@comcast.net",
            "affiliation": "N",
            "address_1": "2910 Tricom St Ste 100",
            "city": "North Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294069351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

Verify at the official NPI Registry.