Kelly Waters Lyles, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

15705 Issued in SC

Practice address

360 N Irby St
Florence, SC 29501-2808

Phone

(843) 667-9414

Fax

(843) 667-1362

NPI assigned

Feb 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.lyles@hop.eclinicaldirectplus.com

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.

• Hopehealth Inc

  • Federally Qualified Health Center (FQHC)
  • Florence, SC
  • NPI 1821002411
  Medicare reassignment NPD
• Hopehealth Inc

  • Federally Qualified Health Center (FQHC)
  • Lake City, SC
  • NPI 1649069618
  NPD
• Hopehealth, Inc

  • Federally Qualified Health Center (FQHC)
  • Lake City, SC
  • NPI 1831442854
  NPD

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464048000000",
    "number": "1073585550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 N IRBY ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295012808",
            "telephone_number": "843-667-9414",
            "fax_number": "843-667-1362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 N IRBY ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295012808",
            "telephone_number": "843-667-9414",
            "fax_number": "843-667-1362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYLES",
        "first_name": "KELLY",
        "middle_name": "WATERS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2016-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "15705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luxottica Retail North America Inc
• Rachelle Lydell, OTD, MSOT, OTR/L
• Lydes Medical Supplies
• Callie Rumfelt Lyew, APRN, FNP-C
• Diane Lyles
• Lymin Inc
• Christy Lynch
• Jenna Ann Lynch, RN
• Onza Lynch
• Deanna Lyttle, M.D

• Internal Medicine Physician in Florence, SC
• Providers in Florence, SC by specialty
• Internal Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.