NPIMap

Individual provider Active NPI

Kimberly N Spivey, FNP-BC

  • Family Nurse Practitioner
  • Aynor, SC
National Provider Identifier
1013280031
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
17728 Issued in SC
Practice address
51 11TH Ave
Aynor, SC 29511-3249
Phone
(843) 358-3700
Fax
(843) 358-3707
NPI assigned
Feb 22, 2012
Last updated
Feb 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 17728 APRN SC
Family Nurse Practitioner 363LF0000X 17728 SC Primary

Addresses

Primary practice location

51 11TH Ave
Aynor, SC 29511-3249

Mailing address

300 Singleton Ridge Rd
Attention PNS Credentialing
Conway, SC 29526-9142
Phone (843) 234-6946

Other identifiers 1

IdentifierTypeStateIssuer
NP2021MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120504000362 SC Practitioner - Nurse Practitioner 6507028701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Carolina School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLeod Health CherawGroup PAC ID 7911228259, 35 clinicians

Practice addresses (Care Compare)

3032 E Hwy 76
Mullins, SC 29574-7396
Phone (843) 464-7111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
17728 APRNSCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Health Cheraw CurrentSince Nov 5, 2023 Accepting new patients
McLeod Health Cheraw Current Accepting new patients
McLeod Health Cheraw CurrentSince Nov 5, 2023 Accepting new patients
McLeod Physician Associates, Inc Family Past Accepting new patients

Locations

711 Chesterfield Hwy
Cheraw, SC 29520
Phone (843) 320-3304

3032 E Highway 76
Mullins, SC 29574
Phone (843) 292-7300

Interoperability endpoints

  • Direct secure messaging: kspivey87895@directmcleodehealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 21

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1329868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1013280031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SINGLETON RIDGE RD",
            "address_2": "ATTENTION PNS CREDENTIALING",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269142",
            "telephone_number": "843-234-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 11TH AVE",
            "city": "AYNOR",
            "state": "SC",
            "postal_code": "295113249",
            "telephone_number": "843-358-3700",
            "fax_number": "843-358-3707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIVEY",
        "first_name": "KIMBERLY",
        "middle_name": "N",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-22",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "17728 APRN",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "17728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP2021",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aynor, SC

Sources for this page

Verify at the official NPI Registry.