MEDICARE: ALEXIS FELTY PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	5921	SC

General Provider Information

NPI Number	:	1932081023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS FELTY PA-C

Provider Business Mailing Address
First Line	:	300 E MCBEE AVE FL 4
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29601-2842
Country	:	US
Telephone Number	:	864-695-6697
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 N SUMTER ST STE 202
Second Line	:
City	:	SUMTER
State	:	SC
Zip	:	29150-4975
Country	:	US
Telephone Number	:	803-774-9797
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2025
Last Update Date	:	12/08/2025

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