Lisa Fanning Etheridge, FNP/APRN - Medicare Nurse Practitioner in Orangeburg, SC

Lisa Fanning Etheridge, FNP/APRN is a medicare enrolled "Nurse Practitioner - Family" in Orangeburg, South Carolina. She graduated from nursing school in 2016 and has 8 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Musc Community Physicians and her current practice location is 1175 Cook Rd Ste 320, Orangeburg, South Carolina. You can reach out to her office (for appointments etc.) via phone at (803) 395-3960.

Lisa Fanning Etheridge is licensed to practice in South Carolina (license number 20081) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1245784669.

Contact Information

Lisa Fanning Etheridge, FNP/APRN
1175 Cook Rd Ste 320,
Orangeburg, SC 29118-8247
(803) 395-3960
Not Available



Provider's Profile

Full NameLisa Fanning Etheridge
GenderFemale
SpecialityNurse Practitioner
Experience8 Years
Location1175 Cook Rd Ste 320, Orangeburg, South Carolina
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Lisa Fanning Etheridge graduated from nursing school in 2016
  NPI Data:
  • NPI Number: 1245784669
  • Provider Enumeration Date: 08/15/2016
  • Last Update Date: 07/21/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 1759656242
  • Enrollment ID: I20171010000678

Medical Identifiers

Medical identifiers for Lisa Fanning Etheridge such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1245784669NPI-NPPES
7389OtherMEDICARE GROUP PTAN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 20081 (South Carolina)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Musc Medical CenterCharleston, SCHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Musc Community Physicians6507260668698

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Lisa Fanning Etheridge allows following entities to bill medicare on her behalf.
Entity NameThe Regional Medical Center Of Orangeburg And Calhoun Counties
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1164496527
PECOS PAC ID: 8527970771
Enrollment ID: O20040202001087

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Entity NameEdisto Regional Health Services Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1285692681
PECOS PAC ID: 4981693447
Enrollment ID: O20040810000307

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Entity NameMusc Community Physicians
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1841878006
PECOS PAC ID: 6507260668
Enrollment ID: O20210811002388

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lisa Fanning Etheridge is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice 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

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› Verified 2 days ago


Nurse Practitioner Nurses in Orangeburg, SC

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: Not Enrolled in Medicare
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    
Jennifer Haynes,
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 970 Holly St, Orangeburg, SC 29115
Phone: 803-531-2722    Fax: 803-531-2743

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