NPIMap

Individual provider Active NPI

Keely Flynn Hudgins, MPH,RD, LD

  • Registered Dietitian
  • Charleston, SC
National Provider Identifier
1043762743
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1320 Issued in SC
Practice address
2093 Henry Tecklenburg Dr Ste 202E
Charleston, SC 29414-5783
Phone
(843) 958-2590
Fax
(843) 402-1972
NPI assigned
Oct 28, 2016
Last updated
Feb 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1320 SC Primary

Addresses

Primary practice location

2093 Henry Tecklenburg Dr Ste 202E
Charleston, SC 29414-5783

Mailing address

PO Box 751649
Charlotte, NC 28275-1649
Phone (843) 789-1620

Other identifiers 1

IdentifierTypeStateIssuer
DT1107MedicaidSC

Other names 1

  • Keely B Flynn Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161215001293 SC Practitioner - Registered Dietitian Or Nutrition Professional 3577843259 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol Current Accepting new patients
Roper Saint Francis Physicians Network Current Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Aug 5, 2019 Accepting new patients
Medical University Hospital Authority CurrentSince Oct 1, 2016 Accepting new patients
Lowcountry Street Grocery Dietitian, Registered CurrentSince Apr 29, 2022 Accepting new patients
Medical University Hospital Authority CurrentSince Oct 1, 2016 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Aug 5, 2019 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Nov 21, 2016 Accepting new patients

Locations

1108 Wappoo Rd
Charleston, SC 29407
Phone (843) 609-8188

1108 Wappoo Rd
Ste 2
Charleston, SC 29407
Phone (843) 609-8188

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

2093 Henry Tecklenburg Dr
#202E
Charleston, SC 29414
Phone (843) 720-5665

2093 Henry Tecklenburg Dr
Ste 202E
Charleston, SC 29414
Phone (843) 720-5665

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

Interoperability endpoints

  • Direct secure messaging: khudgins1236126@direct.bsmhealth.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1477612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1043762743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "843-789-1620",
            "fax_number": "843-724-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2093 HENRY TECKLENBURG DR STE 202E",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145783",
            "telephone_number": "843-958-2590",
            "fax_number": "843-402-1972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN HUDGINS",
        "first_name": "KEELY",
        "credential": "MPH,RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-28",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "SC",
            "license": "1320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DT1107",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEELY",
            "last_name": "FLYNN",
            "middle_name": "B",
            "credential": "MPH,RD, LD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.