Active NPI
Kelsey Klostermeyer McDill, M.D.
- Pediatrics Physician
- Blythewood, SC
National Provider Identifier
1003298647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- LL38204
- Practice address
- 121 Blythewood Rd
Blythewood, SC 29016-8426 - Phone
- (803) 788-6360
- Fax
- (803) 462-0312
- NPI assigned
- Jun 19, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | LL38204 | SC | Primary |
Addresses
Primary practice location
121 Blythewood Rd
Blythewood, SC 29016-8426
Mailing address
601 Clemson Rd
Columbia, SC 29229-4341
Phone (803) 788-6146
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160902001407 | SC | Order and Referring Only - Pediatric Medicine | 9739475542 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL38204 | SC | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Carolina Pediatrics Alliance, LLC | Past | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatric Adolescent Medicine Physician
- Columbia, SC
- NPI 1184016941
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562803200000",
"number": "1003298647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 CLEMSON RD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292294341",
"telephone_number": "803-788-6146",
"fax_number": "803-462-0312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 BLYTHEWOOD RD",
"city": "BLYTHEWOOD",
"state": "SC",
"postal_code": "290168426",
"telephone_number": "803-788-6360",
"fax_number": "803-462-0312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDILL",
"first_name": "KELSEY",
"middle_name": "KLOSTERMEYER",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-19",
"last_updated": "2019-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "SC",
"license": "LL38204",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blythewood, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.