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LISA FANNING ETHERIDGE FNP/APRN
NPI 1245784669
Nurse Practitioner - Family in Orangeburg, SC

Active since August 15, 2016PECOS EnrolledAccepts Medicare Assignment
1175 COOK RD STE 320, ORANGEBURG, SC 29118(803) 395-3960 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Mar 17, 2018, Feb 13, 2018 and 2 more (5 updates tracked since 2016).

About Lisa Fanning Etheridge Fnp/aprn NPPES

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

LISA FANNING ETHERIDGE FNP/APRN (NPI 1245784669) is an individual family provider in Orangeburg, South Carolina, licensed in South Carolina (20081) and active in the NPI registry since August 2016. She is enrolled in Medicare PECOS, is affiliated with Musc Medical Center, and maintains a secondary practice location in Barnwell.

NPPES Registry Identity

NPI1245784669
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameLISA FANNING ETHERIDGECredential: FNP/APRN
Location Address1175 COOK RD STE 320Orangeburg, SC 29118-8247
Mailing Address914 Reynolds RdBarnwell, SC 29812 · (803) 259-5311
Phone(803) 395-3960
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateAugust 15, 2016
Last NPPES UpdateJuly 21, 20225 updates tracked since enumeration
✔ NPI 1245784669 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in SC · 20081
1175 COOK RD STE 320, Orangeburg, SC 29118
Open in Google Maps ↗

Other Names 1

Former Name (1)Lisa Fanning Smith

Secondary Practice Location 1

Location 1914 Reynolds RdBarnwell, SC 29812-6358 · Phone (803) 259-5311

Other Identifiers 1

Other7389Medicare Group Ptan

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina 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

Lisa Fanning Etheridge Fnp/aprn 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 ID1759656242
PECOS Enrollment IDI20171010000678
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.

Hospital Affiliations CMS Care Compare

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

Musc Medical Center

Acute Care Hospitals · Charleston, SC
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number420004
Location169 Ashley AveCharleston, SC 29425 · Charleston County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29118 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 4

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

THE REGIONAL MEDICAL CENTER OF ORANGEBURG AND CALHOUN COUNTIES
Surgery
1175 COOK RD STE 320
ORANGEBURG, SC 29118
Orangeburg County (803) 395-3960
THE REGIONAL MEDICAL CENTER OF ORANGEBURG AND CALHOUN COUNTIES
Surgery
1175 COOK RD STE 320
ORANGEBURG, SC 29118
Orangeburg County (803) 536-2555
CHELSEA SARAH NYPAVER NP-C
Nurse Practitioner (Family)
1175 COOK RD STE 320
ORANGEBURG, SC 29118
Orangeburg County (803) 395-3960
HOLLY DUNN CLARDY APRN
Nurse Practitioner (Family)
1175 COOK RD STE 320
ORANGEBURG, SC 29118
Orangeburg County (803) 395-3960

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lisa Etheridge's NPI number?

The NPI number for Lisa Etheridge is 1245784669. It was assigned to this individual provider in the NPPES registry on August 15, 2016. The provider is also known as Lisa Fanning Smith.

Where is Lisa Etheridge located?

Lisa Etheridge practices at 1175 Cook Rd Ste 320, Orangeburg, SC 29118. The listed phone number is (803) 395-3960.

What is Lisa Etheridge's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Lisa Etheridge enrolled in Medicare?

Yes. Lisa Etheridge is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Lisa Etheridge accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and First Choice Next list Lisa Etheridge as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Lisa Etheridge affiliated with any hospitals?

According to CMS data, Lisa Etheridge is affiliated with Musc Medical Center.

When was this NPI record last updated?

The NPPES record for Lisa Etheridge was last updated on July 21, 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.