Active NPI
Kristen Chicola Neil, M.D.
- Pediatrics Physician
- Lexington, SC
National Provider Identifier
1104269646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2016-00952
- Practice address
- 424 Old Cherokee Rd
Lexington, SC 29072-6972 - Phone
- (803) 520-5800
- Fax
- (803) 520-5972
- NPI assigned
- Apr 15, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 2016-00952 | NC | Primary |
Addresses
Primary practice location
424 Old Cherokee Rd
Lexington, SC 29072-6972
Mailing address
424 Old Cherokee Rd
Lexington, SC 29072-6972
Phone (803) 520-5800
Other practice location 1
213 Spring Creek Ct
Lexington, SC 29072-7948
Phone (770) 856-7506
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2016-00952 | NC | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Medical Management, LLC | Pediatrics | Current | Accepting new patients |
| Sweetgrass Pediatrics | Pediatrics | Past | Accepting new patients |
Locations
2214 Old Cherokee Rd
Lexington, SC 29072
424 Old Cherokee Rd
Lexington, SC 29072
Phone (800) 352-0580
Organizations & group practices 2
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": "1365984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604534400000",
"number": "1104269646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "424 OLD CHEROKEE RD",
"city": "LEXINGTON",
"state": "SC",
"postal_code": "290726972",
"telephone_number": "803-520-5800",
"fax_number": "803-520-5972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "424 OLD CHEROKEE RD",
"city": "LEXINGTON",
"state": "SC",
"postal_code": "290726972",
"telephone_number": "803-520-5800",
"fax_number": "803-520-5972"
}
],
"practiceLocations": [
{
"address_1": "213 Spring Creek Ct",
"address_purpose": "LOCATION",
"city": "Lexington",
"state": "SC",
"postal_code": "290727948",
"country_code": "US",
"telephone_number": "770-856-7506",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NEIL",
"first_name": "KRISTEN",
"middle_name": "CHICOLA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-15",
"last_updated": "2020-11-05",
"certification_date": "2020-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "2016-00952",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.