KELLI S DAUGHTRY
NPI 1154977916
Physician Assistant in Georgetown, SC

Q: What is Kelli Daughtry's NPI number?

The NPI number for Kelli Daughtry is 1154977916. It was assigned to this individual provider in the NPPES registry on August 16, 2019.

Q: What is Kelli Daughtry's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Kelli Daughtry was last updated on November 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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 August 16, 2019PECOS EnrolledAccepts Medicare Assignment

1014 HUGER DR, GEORGETOWN, SC 29440(843) 520-8780(843) 652-8399 Get Directions Write a Review

NPPES record last updated: November 13, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 13, 2025, Jul 2, 2025, Aug 16, 2022 and 3 more (6 updates tracked since 2019).

On this page

About Kelli S Daughtry NPPES

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

KELLI S DAUGHTRY (NPI 1154977916) is an individual physician assistant in Georgetown, South Carolina, licensed in North Carolina (00010-10521) and active in the NPI registry since August 2019. She is enrolled in Medicare PECOS, is affiliated with Tidelands Waccamaw Community Hospital, and maintains 5 additional practice locations.

NPPES Registry Identity

NPI1154977916

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameKELLI S DAUGHTRY

Location Address1014 HUGER DRGeorgetown, SC 29440-3322

Mailing AddressPo Box 421718Georgetown, SC 29442-4203 · (843) 527-7000

Phone(843) 520-8780

Fax(843) 652-8399

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateAugust 16, 2019

Last NPPES UpdateNovember 13, 20256 updates tracked since enumeration

NPPES CertifiedNovember 13, 2025

✔ NPI 1154977916 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in NC · 00010-10521

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1014 HUGER DR, Georgetown, SC 29440

Open in Google Maps ↗

Secondary Practice Locations 5

Location 12200 Crow Ln Ste 303BMyrtle Beach, SC 29577-1663 · Phone (843) 520-8780 · Fax (843) 652-8399

Location 24040 Highway 17 Unit 104Murrells Inlet, SC 29576-5098 · Phone (843) 652-8390 · Fax (843) 652-8399

Location 35115 Oleander DrWilmington, NC 28403-7018 · Phone (910) 362-1011

Location 41014 Huger DRGeorgetown, SC 29440-3322 · Phone (843) 520-8780 · Fax (843) 652-8399

Location 5606 Black River Rd Ste 301Georgetown, SC 29440-3304 · Phone (843) 652-8390 · Fax (843) 652-8399

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, BlueCross BlueShield of South Carolina, First Choice Next and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelli S Daughtry is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5496167751

PECOS Enrollment IDI20250306000320

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.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

162 services134 patients

Strapping, unna boot 29580

An Unna Boot is a special bandage, soaked in a gel, wrapped around your lower leg and foot. It helps heal leg sores, improve circulation, and reduce swelling. The boot hardens and provides compression, promoting healing and comfort.

27 services16 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

11 services11 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

11 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Tidelands Waccamaw Community Hospital

Acute Care Hospitals · Murrells Inlet, SC

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number420098

Location4070 Hwy 17Murrells Inlet, SC 29576 · Horry County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29440 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

$67.12 typical visit price

range $16.96 – $133.52

Typical copayment $16.78 (range $4.24 – $33.38)

Most-billed visit code 99213

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 6

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

DR. JACOB ROBERTO ORTIZ MD

Internal Medicine (Cardiovascular Disease)