NPIMap

Organization Active NPI

KB Management Services LLC

  • Emergency Medicine Physician
  • Hartsville, SC
National Provider Identifier
1053459818
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
011678 Issued in SC
Legal business name
KB MANAGEMENT SERVICES LLC
Practice address
1304 W Bobo Newsom Hwy
Hartsville, SC 29550-4710
Phone
(843) 339-4600
NPI assigned
Feb 2, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
James C Balich, MD
Title
Manager
Phone
(843) 639-9509

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 011678 SC Primary

Addresses

Primary practice location

1304 W Bobo Newsom Hwy
Hartsville, SC 29550-4710

Mailing address

1121 S 4TH St
Hartsville, SC 29550-0700
Phone (843) 639-9509

Other identifiers 1

IdentifierTypeStateIssuer
GP3064MedicaidSC

National Provider Directory

National Provider Directory

Locations

939 14th Ln
Vero Beach, FL 32960

1121 S 4th St
Hartsville, SC 29550

Practitioners & affiliated clinicians

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053459818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 S 4TH ST",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295500700",
            "telephone_number": "843-639-9509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 W BOBO NEWSOM HWY",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295504710",
            "telephone_number": "843-339-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KB MANAGEMENT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BALICH",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "843-639-9509",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "011678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3064",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartsville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.