Individual provider Active NPI

Kenneth A Sharpe, MD

  • Ophthalmology Physician
  • Charleston, SC
National Provider Identifier
1013023340
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
10062 Issued in SC
Practice address
3531 Mary Ader Ave
Charleston, SC 29414-5896
Phone
(843) 352-0674
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 10062 SC Primary

Addresses

Primary practice location

3531 Mary Ader Ave
Charleston, SC 29414-5896

Mailing address

PO Box 63350
Charlotte, NC 28263-0001
Phone (843) 352-0674

Other identifiers 1

IdentifierTypeStateIssuer
100624MedicaidSC

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040805000368 SC Practitioner - Ophthalmology 1254238058 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
100624SCMDInfusion Therapy Registered Nurse
10062SCMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Neurosciences Institute Ophthalmology CurrentSince Jul 4, 2009 Accepting new patients
Charleston Neuroscience Institute LLC CurrentSince Jul 4, 2009 Accepting new patients
The Retina Center of Charleston, PA Past Accepting new patients
Carolina Eyecare Physicians LLC Ophthalmology Past Accepting new patients

Locations

3531 Mary Ader Ave
Ste D
Charleston, SC 29414

3531 Mary Ader Ave
Charleston, SC 29414
Phone (843) 352-0674

9565 Highway 78
Bldg 300
Ladson, SC 29456
Phone (843) 412-2339

Interoperability endpoints

  • Direct secure messaging: ksharpe@retinacharleston.intellechartdirect.net

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421107200000",
    "number": "1013023340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 63350",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282630001",
            "telephone_number": "843-352-0674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3531 MARY ADER AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145896",
            "telephone_number": "843-352-0674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARPE",
        "first_name": "KENNETH",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2015-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "10062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100624",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.