NPIMap

Individual provider Active NPI

Keith Thomas Lonergan, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Greer, SC
National Provider Identifier
1104962703
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
30396 Issued in SC
Practice address
315 Medical Pkwy
Suite 100
Greer, SC 29650-2456
Phone
(864) 454-7422
Fax
(864) 797-9701
NPI assigned
Jan 30, 2007
Last updated
Nov 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 30396 SC
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 30396 SC Primary

Addresses

Primary practice location

315 Medical Pkwy
Suite 100
Greer, SC 29650-2456

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other identifiers 3

IdentifierTypeStateIssuer
576007863179OtherSCBCBS
G51248MedicaidSC
P00607534OtherSCRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071211000037 SC Practitioner - Orthopedic Surgery 2062470693 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Pennsylvania State University College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

210 Freeman Farm Rd
Duncan, SC 29334-9398
Phone (864) 968-5123

300 E McBee Ave
Greenville, SC 29601-2842
Phone (864) 797-6220

300 E McBee Ave FL
Suite 4
Greenville, SC 29601-2842

315 Medical Pkwy
Suite 100
Greer, SC 29650-2455
Phone (864) 797-9700

701 Grove Rd
Greenville, SC 29605-4210

830 S Buncombe Rd
Greer, SC 29650-2400
Phone (864) 455-2455

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement22
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)93

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30396SCMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jan 1, 2010 Accepting new patients
Greenville Health System CurrentSince Nov 1, 2007 Accepting new patients
Prisma Health University Medical Group CurrentSince Jan 1, 2010 Accepting new patients
Greenville Health System Current Accepting new patients
Orthopaedic Associates of Augusta PA Orthopaedic Surgery Past Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

200 Patewood Dr
Bldg A
Greenville, SC 29615
Phone (864) 454-2604

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

315 Medical Pkwy
Ste 100
Greer, SC 29650
Phone (864) 454-7422

719A SE Main St
Simpsonville, SC 29681
Phone (864) 967-9000

807 N Main St
Travelers Rst, SC 29690
Phone (864) 834-5132

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17761/brand/1/csg/1/fhir/r4
  • Direct secure messaging: klonergan5655@direct.ghs.myhfn.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 51

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

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1104962703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 MEDICAL PKWY",
            "address_2": "SUITE 100",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296502456",
            "telephone_number": "864-454-7422",
            "fax_number": "864-797-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONERGAN",
        "first_name": "KEITH",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "SC",
            "license": "30396",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "SC",
            "license": "30396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "576007863179",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G51248",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00607534",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

Verify at the official NPI Registry.