Individual provider Active NPI

Kenneth Boyce Sammons

  • Peer Specialist
  • Pickens, SC
National Provider Identifier
1124604673
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
CPRS-2182 Issued in SC
Practice address
309 E Main St
Pickens, SC 29671-2319
Phone
(864) 898-5800
NPI assigned
Mar 23, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X CPRS-2182 SC Primary

Addresses

Primary practice location

309 E Main St
Pickens, SC 29671-2319

Mailing address

PO Box 345
Norris, SC 29667-0345

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

State licenses

LicenseStateTypeSpecialty
CPRS-2182SCMDPeer Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Pickens County Commission on Alcohol & Drug Abuse CurrentSince Apr 28, 2024 Accepting new patients
Pickens County Commission on Alcohol & Drug Abuse PastSince Mar 28, 2021 Accepting new patients

Locations

309 E Main St
Pickens, SC 29671
Phone 3306395336 ext. 33063

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": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1124604673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 345",
            "city": "NORRIS",
            "state": "SC",
            "postal_code": "296670345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 E MAIN ST",
            "city": "PICKENS",
            "state": "SC",
            "postal_code": "296712319",
            "telephone_number": "864-898-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMMONS",
        "first_name": "KENNETH",
        "middle_name": "BOYCE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-23",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "SC",
            "license": "CPRS-2182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pickens, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.