Provider Demographics
NPI:1659259331
Name:IVEY, JAMES DAVIS (PA-C)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:DAVIS
Last Name:IVEY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 WESTEDGE ST APT 344
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-4987
Mailing Address - Country:US
Mailing Address - Phone:843-319-8118
Mailing Address - Fax:
Practice Address - Street 1:99 WESTEDGE ST APT 344
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403-4987
Practice Address - Country:US
Practice Address - Phone:843-319-8118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program