Individual provider Active NPI

Kimberly A Kay, PA-C

  • Surgical Physician Assistant
  • North Charleston, SC
National Provider Identifier
1043328008
Registry record updated Mar 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA1230 Issued in SC
Practice address
2880 Tricom St
North Charleston, SC 29406-9171
Phone
(843) 797-5050
Fax
(843) 797-3633
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA1230 SC Primary

Addresses

Primary practice location

2880 Tricom St
North Charleston, SC 29406-9171

Mailing address

2880 Tricom St
North Charleston, SC 29406-9171
Phone (843) 797-5050

Other identifiers 1

IdentifierTypeStateIssuer
1014PAMedicaidSC

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080124000011 SC Practitioner - Physician Assistant 7517049901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arcis Healthcare LLCGroup PAC ID 0042448748, 34 clinicians

Practice addresses (Care Compare)

2880 Tricom St
North Charleston, SC 29406-9171
Phone (843) 797-5050

Hospital & facility affiliations

  • Trident Medical Center Hospital, Charleston, SC, CCN 420079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA1230SCMDSurgical Physician Assistant
1230SCMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Arcis Healthcare, LLC Surgical CurrentSince Dec 1, 2017 Accepting new patients
Arcis Healthcare, LLC CurrentSince Dec 1, 2017 Accepting new patients
Doctors Care, PA Past Accepting new patients

Locations

1951 Clements Ferry Rd
Ste 100
Charleston, SC 29492
Phone (843) 797-5050

2880 Tricom St
North Charleston, SC 29406
Phone (843) 797-5050

93 Springview Ln
Unit B
Summerville, SC 29485
Phone (843) 266-4883

130 E 3rd North St
Summerville, SC 29483
Phone (843) 797-5050

Interoperability endpoints

  • Direct secure messaging: kimberly.kay.1@7388.direct.athenahealth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1043328008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 TRICOM ST",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069171",
            "telephone_number": "843-797-5050",
            "fax_number": "843-797-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 TRICOM ST",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069171",
            "telephone_number": "843-797-5050",
            "fax_number": "843-797-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAY",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SC",
            "license": "PA1230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1014PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

Verify at the official NPI Registry.