NPIMap

Individual provider Active NPI

Kevin Carlson

  • Otolaryngology Physician
  • Greenville, SC
National Provider Identifier
1124523170
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
92143 Issued in SC
Practice address
200 Patewood Dr Ste B400
Greenville, SC 29615-6306
Phone
(864) 454-4368
Fax
(864) 241-9232
NPI assigned
Mar 29, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Otolaryngology Physician 207Y00000X 82003 WI
Otolaryngology Physician 207Y00000X 92143 SC Primary

Addresses

Primary practice location

200 Patewood Dr Ste B400
Greenville, SC 29615-6306

Mailing address

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

Other practice location 1

600 Gresham Dr Ste 1100
Norfolk, VA 23507-1904
Phone (757) 388-6200

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
I20241007002616 SC Practitioner - Otolaryngology 8325395148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Virginia School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

200 Patewood Dr
Suite B400
Greenville, SC 29615-6306
Phone (864) 454-4368

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.32 of 100Reported as group
Quality
87.78
Promoting interoperability
77
Improvement activities
40
Cost
75.8

Merit-based Incentive Payment System (MIPS)

Final score
84.33 of 100Reported as group
Quality
75.48
Promoting interoperability
100
Improvement activities
40
Cost
72.29

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision19
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
92143SCMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Sep 30, 2024 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Jul 1, 2023 Accepting new patients
Prisma Health University Medical Group CurrentSince Sep 30, 2024 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Jul 1, 2023 Accepting new patients
Evms Academic Physicians and Surgeons Health Services Foundation Otolaryngology Past Accepting new patients

Locations

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

200 Patewood Dr
Ste B400
Greenville, SC 29615
Phone (864) 454-4368

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

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

105 Carter Park Dr
Ste B
Seneca, SC 29678
Phone (864) 482-3122

402 W Lake St
Friendship, WI 53934
Phone (608) 339-3331

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

1040 Division St
Mauston, WI 53948
Phone (608) 847-5000

7974 Uw Health Ct
Middleton, WI 53562
Phone (608) 829-5270

Interoperability endpoints

  • Direct secure messaging: kcarlson818627@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 and National Provider Directory roles.

Hospital & facility affiliations 56

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

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1124523170",
    "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": "200 PATEWOOD DR STE B400",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156306",
            "telephone_number": "864-454-4368",
            "fax_number": "864-241-9232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Gresham Dr Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235071904",
            "country_code": "US",
            "telephone_number": "757-388-6200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "KEVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-29",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WI",
            "license": "82003",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "SC",
            "license": "92143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.