Kynlea Butler, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA4397 Issued in SC

Practice address

2022 Cardinal Cir
Anderson, SC 29621-1504

Phone

(864) 224-7577

Fax

(864) 225-5165

NPI assigned

Apr 24, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Kynlea Brantley Former name

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

Specialty

Physician Assistant

Education

Mercer University School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Epiphany Dermatology of South Carolina LLCGroup PAC ID 8527049865, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Epiphany Dermatology of South Carolina LLC

  • Dermatology Physician
  • Greenville, SC
  • NPI 1861565996
  Medicare reassignment Care Compare group
• Dermatology and Laser Center of Charleston PA

  • Dermatology Physician
  • Charleston, SC
  • NPI 1124198361
  NPD (past)
• Georgia Dermatology &Skin Cancer Center, PC

  • Dermatology Physician
  • Macon, GA
  • NPI 1447363346
  NPD (past)

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

{
    "created_epoch": "1556064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1043874142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 FALLS ST UNIT 404",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296013554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2022 CARDINAL CIR",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296211504",
            "telephone_number": "864-224-7577",
            "fax_number": "864-225-5165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "KYNLEA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-24",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "PA4397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYNLEA",
            "last_name": "BRANTLEY",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mae Deette Thompson Burton, F.N.P.
• Michelle R Burton
• Terry Kaye Hanks Busby, MS, APRN, FNP-BC
• Lindsay M. Busha, O.T.
• Danielle Buske
• Susan Butler, LPN
• Christine Buttrey, RD, LD
• Karen Butts, RN
• Jada Byrd
• Melanie Blackburn Cabaniss, DPT

• Physician Assistant in Anderson, SC
• Providers in Anderson, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.