| Lisa Fanning Etheridge, FNP/APRN | |
|
1175 Cook Rd Ste 320, Orangeburg, SC 29118-8247 | |
| (803) 395-3960 | |
| Not Available |
| Full Name | Lisa Fanning Etheridge |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 8 Years |
| Location | 1175 Cook Rd Ste 320, Orangeburg, South Carolina |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245784669 | NPI | - | NPPES |
| 7389 | Other | MEDICARE GROUP PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 20081 (South Carolina) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Musc Medical Center | Charleston, SC | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Musc Community Physicians | 6507260668 | 793 |
| Entity Name | The Regional Medical Center Of Orangeburg And Calhoun Counties |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164496527 PECOS PAC ID: 8527970771 Enrollment ID: O20040202001087 |
| Entity Name | Edisto Regional Health Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285692681 PECOS PAC ID: 4981693447 Enrollment ID: O20040810000307 |
| Entity Name | Musc Community Physicians |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1841878006 PECOS PAC ID: 6507260668 Enrollment ID: O20210811002388 |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Fanning Etheridge, FNP/APRN 914 Reynolds Rd, Barnwell, SC 29812 Ph: (803) 259-5311 | Lisa Fanning Etheridge, FNP/APRN 1175 Cook Rd Ste 320, Orangeburg, SC 29118-8247 Ph: (803) 395-3960 |
Catherine Simmons, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3310 Magnolia Centers Inc, Orangeburg, SC 29115 Phone: 843-701-6387 | |
Shannon W Easterlin, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 940 Holly St, Orangeburg, SC 29115 Phone: 803-536-2725 Fax: 803-534-3118 | |
Monica Monique Johnson, PMHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3000 Saint Matthews Rd, Orangeburg, SC 29118 Phone: 803-395-2200 | |
Constance Gainey Bailey, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3000 Saint Matthews Rd, Orangeburg, SC 29118 Phone: 803-395-2200 | |
Vincent Bernard Johnson, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3310 Magnolia St, Orangeburg, SC 29115 Phone: 803-531-6900 | |
Ms. Erica Thompson, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1773 Village Park Drive, Orangeburg, SC 29118 Phone: 803-535-3600 | |
Cortney Powell, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3045 Saint Matthews Rd, Orangeburg, SC 29118 Phone: 803-747-7242 Fax: 803-747-7243 |