Kahlil Ahmadi Demonbreun, DNP, WHNP-BC, ANP-BC

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

APRN 2202 Issued in SC

Practice address

6439 Garners Ferry Rd
Columbia, SC 29209-1638

Phone

(803) 776-4000

NPI assigned

Aug 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1124036728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6439 GARNERS FERRY RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292091638",
            "telephone_number": "803-776-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6439 GARNERS FERRY RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292091638",
            "telephone_number": "803-776-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMONBREUN",
        "first_name": "KAHLIL",
        "middle_name": "AHMADI",
        "name_prefix": "Dr.",
        "credential": "DNP, WHNP-BC, ANP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "SC",
            "license": "APRN 2202",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "SC",
            "license": "APRN 2202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NPO649",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madeline Demarsh, PHARMD
• Andrew Demas, DMD
• Shakiyah Delania Demelien
• Laura Demian, PHARMD
• Sylvia Demian, PHARMD
• Lucas Demonte, LCMHC,LMHC, LPC, NCC
• Kevin Brian Dempsey, PSY.D.
• Dena McKeown
• Syreeta Dendy, NP-C
• Fang Emily Deng, M.D.,

• Women's Health Nurse Practitioner in Columbia, SC
• Providers in Columbia, SC by specialty
• Women's Health Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; 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.