Charles A. Kolb, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11866 Issued in SC

Practice address

901 W Greenwood St
Suite 9
Abbeville, SC 29620-5678

Phone

(864) 366-9681

Fax

(864) 366-5600

NPI assigned

May 27, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ckolb57264@selfregional.direct-ci.net

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.

• Abbeville County Memorial Hospital

  • Critical Access Hospital
  • Abbeville, SC
  • NPI 1063449361

  SC

  Medicare reassignment NPD
• Abbeville County Memorial Hospital

  • Adult Medicine Physician
  • Due West, SC
  • NPI 1689048464

  Family Medicine

  NPD
• Abbeville County Memorial Hospital

  • Family Medicine Physician
  • Abbeville, SC
  • NPI 1285618132

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1043213622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 968",
            "city": "ABBEVILLE",
            "state": "SC",
            "postal_code": "296200968",
            "telephone_number": "864-366-9681",
            "fax_number": "864-366-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W GREENWOOD ST",
            "address_2": "SUITE 9",
            "city": "ABBEVILLE",
            "state": "SC",
            "postal_code": "296205678",
            "telephone_number": "864-366-9681",
            "fax_number": "864-366-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLB",
        "first_name": "CHARLES",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "11866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118660",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bruce Samuel Johnston, M.D.
• Joseph Frank Jones, LMSW
• K. W. Ballentine, MD, PA
• Julie Knox, PHARM.D
• Sandy Knox, R.N.
• Alisa M Kollmann, MOT, OTR/L
• Lakelands Orthopaedic Clinic
• Larry D. Lawson DDS PA
• Rachel L Latham, LPC, LAC
• Lawson Family Dental Care LLC

• All providers in Abbeville, SC
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; 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.

Verify at the official NPI Registry.