STACEY LYNN CHILDRESS AGPCNP
NPI 1083018030
Nurse Practitioner - Adult Health in Charleston, SC

Q: What is Stacey Childress's NPI number?

The NPI number for Stacey Childress is 1083018030. It was assigned to this individual provider in the NPPES registry on October 20, 2014.

Q: What is Stacey Childress's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Q: When was this NPI record last updated?

The NPPES record for Stacey Childress was last updated on May 31, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 20, 2014PECOS Enrolled

316 CALHOUN ST, CHARLESTON, SC 29401(843) 724-2450 Get Directions Write a Review

NPPES record last updated: May 31, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Stacey Lynn Childress Agpcnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STACEY LYNN CHILDRESS AGPCNP (NPI 1083018030) is an individual adult health provider in Charleston, South Carolina, licensed in South Carolina (23153) and active in the NPI registry since October 2014. She is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1083018030

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameSTACEY LYNN CHILDRESSCredential: AGPCNP

Location Address316 CALHOUN STCharleston, SC 29401-1113

Mailing AddressPo Box 751649Charlotte, NC 28275-1649 · (843) 789-1620

Phone(843) 724-2450

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateOctober 20, 2014

Last NPPES UpdateMay 31, 2022

NPPES CertifiedMay 31, 2022

✔ NPI 1083018030 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in SC · 23153

316 CALHOUN ST, Charleston, SC 29401

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stacey Lynn Childress Agpcnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3476876616

PECOS Enrollment IDI20220714003379

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29401 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.18 typical visit price

range $53.57 – $163.84

Typical copayment $20.79 (range $13.39 – $40.96)

Most-billed visit code 99203

Established Patient

$95.12 typical visit price

range $16.96 – $133.52

Typical copayment $23.78 (range $4.24 – $33.38)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHRISTIAN ANTON SUNG PA-C

Physician Assistant