Active NPI
Larry E Kibler, M.D.
- Cardiovascular Disease Physician
- Spartanburg, SC
National Provider Identifier
1003868431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 7082
- Practice address
- 1083 Boiling Springs Rd
Spartanburg, SC 29303-2248 - Phone
- (864) 583-8647
- Fax
- (864) 542-2227
- NPI assigned
- May 16, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 7082 | SC | Primary |
Addresses
Primary practice location
1083 Boiling Springs Rd
Spartanburg, SC 29303-2248
Mailing address
1083 Boiling Springs Rd
Spartanburg, SC 29303-2248
Phone (864) 583-8647
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 070826 | Medicaid | SC | |
| 26393 | Other | MEDCOST PIN | |
| 4314886 | Other | AETNA PIN | |
| 890662F | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7082 | SC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mary Black Health System LLC | Cardiovascular Disease | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Medicine & Rehabilitation Physician
- Spartanburg, SC
- NPI 1083640981
Cardiovascular Disease
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219795200000",
"number": "1003868431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1083 BOILING SPRINGS RD",
"city": "SPARTANBURG",
"state": "SC",
"postal_code": "293032248",
"telephone_number": "864-583-8647",
"fax_number": "864-542-2227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1083 BOILING SPRINGS RD",
"city": "SPARTANBURG",
"state": "SC",
"postal_code": "293032248",
"telephone_number": "864-583-8647",
"fax_number": "864-542-2227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIBLER",
"first_name": "LARRY",
"middle_name": "E",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-16",
"last_updated": "2008-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "SC",
"license": "7082",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "070826",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST PIN",
"identifier": "26393",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PIN",
"identifier": "4314886",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "890662F",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Spartanburg, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.