Individual provider Active NPI

Teresa Mary Kilgore, DO

  • Internal Medicine Physician
  • Columbia, SC
National Provider Identifier
1063519064
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
279 Issued in SC
Practice address
2601 Laurel St Ste 120
Columbia, SC 29204-2034
Phone
(803) 227-5320
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 279 SC Primary

Addresses

Primary practice location

2601 Laurel St Ste 120
Columbia, SC 29204-2034

Mailing address

255 Enterprise Blvd
Suite 250
Greenville, SC 29615-6300
Phone (864) 454-0888

Other practice location 1

701 Grove Rd
Greenville, SC 29605-5611
Phone (864) 455-6372

Other identifiers 6

IdentifierTypeStateIssuer
576007863OtherSCAETNA
002794MedicaidSC
57-6007863OtherSCBCBS
57-6007863OtherSCBLUE CHOICE
110234017OtherSCMEDICARE RAILROAD
57-6007863OtherSCTRICARE

Other names 1

  • Teresa M Jolley Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.musc.edu Health Information Exchange (HIE)

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090123000509 SC Practitioner - Internal MedicinePractitioner - Osteopathic Manipulative Medicine 3375607054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
80.41 of 100Reported as group
Quality
64.93
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
279SCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Musc Community Physicians CurrentSince Jun 8, 2022 Accepting new patients
Musc Community Physicians Internal Medicine Current Accepting new patients
Musc Community Physicians Internal Medicine CurrentSince Jun 8, 2022 Accepting new patients
Greenville Health System Past Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

2435 Forest Dr
Columbia, SC 29204
Phone (770) 874-6859

120 Gateway Corporate Blvd
Columbia, SC 29203
Phone (803) 256-5320

2601 Laurel St
Ste 120
Columbia, SC 29204
Phone (803) 227-5320

Interoperability endpoints

  • Direct secure messaging: tkilgore400414@direct.musc.edu

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1063519064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 ENTERPRISE BLVD",
            "address_2": "SUITE 250",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156300",
            "telephone_number": "864-454-0888",
            "fax_number": "864-454-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 LAUREL ST STE 120",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042034",
            "telephone_number": "803-227-5320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Grove Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296055611",
            "country_code": "US",
            "telephone_number": "864-455-6372",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILGORE",
        "first_name": "TERESA",
        "middle_name": "MARY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2023-03-07",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "576007863",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002794",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "57-6007863",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "57-6007863",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "110234017",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "57-6007863",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2601 Laurel St Ste 120",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292042034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "JOLLEY",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.