Individual provider Active NPI

Kayla Marie Windham, DNP, APRN, FNP-C

  • Nurse Practitioner
  • Mt Pleasant, SC
National Provider Identifier
1093447518
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26249 Issued in SC
Practice address
570 Long Point Rd Ste 130
Mt Pleasant, SC 29464-7931
Phone
(843) 884-2133
NPI assigned
Jun 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26249 SC Primary
Registered Nurse 163W00000X 231182 SC

Addresses

Primary practice location

570 Long Point Rd Ste 130
Mt Pleasant, SC 29464-7931

Mailing address

2293 Portside Way
Charleston, SC 29407-9657
Phone (843) 696-7987

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220816000276 SC Practitioner - Nurse Practitioner 1254714801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
East Cooper Physician Group LLCGroup PAC ID 1254775687, 126 clinicians

Practice addresses (Care Compare)

570 Long Point Rd
Suite 130
Mt Pleasant, SC 29464-7931
Phone (843) 884-2133

851 Leonard Fulghum Dr
Mt Pleasant, SC 29464-3793

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
231182SCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
East Cooper Physician Group LLC CurrentSince Feb 1, 2024 Accepting new patients
East Cooper Physician Group LLC Current Accepting new patients
East Cooper Physician Group LLC CurrentSince Feb 1, 2024 Accepting new patients
East Cooper Physician Group LLC Past Accepting new patients

Locations

570 Long Point Rd
Ste 130
Mt Pleasant, SC 29464
Phone (843) 849-2596

851 Leonard Fulghum Dr
Ste 101
Mt Pleasant, SC 29464
Phone (843) 884-2133

3400 Salterbeck St
Ste 100B
Mt Pleasant, SC 29466
Phone (843) 856-3262

Interoperability endpoints

  • Direct secure messaging: kayla.windham.1@30548.direct.athenahealth.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1656028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1093447518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2293 PORTSIDE WAY",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294079657",
            "telephone_number": "843-696-7987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 LONG POINT RD STE 130",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294647931",
            "telephone_number": "843-884-2133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINDHAM",
        "first_name": "KAYLA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-24",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "26249",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SC",
            "license": "231182",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, SC

Sources for this page

Verify at the official NPI Registry.