Active NPI
Kenneth Boyce Sammons
- Peer Specialist
- Pickens, SC
National Provider Identifier
1124604673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- CPRS-2182
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| CPRS-2182 | SC | MD | Peer Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pickens County Commission on Alcohol & Drug Abuse | Current | Accepting new patients | |
| Pickens County Commission on Alcohol & Drug Abuse | Past | 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.
-
- Addiction Medicine (Family Medicine) Physician
- Easley, SC
- NPI 1467207209
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Easley, SC
- NPI 1134127475
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.