Individual provider Active NPI

John Kibet Kirui

  • Psychiatric/Mental Health Nurse Practitioner
  • Seneca, SC
National Provider Identifier
1144118084
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
30234 Issued in SC
Practice address
201 Central Park LN Ste a
Seneca, SC 29678-1156
Phone
(864) 844-9432
Fax
(864) 844-9430
NPI assigned
Jun 27, 2025
Last updated
Jun 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 12749 MN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 30234 SC Primary

Addresses

Primary practice location

201 Central Park LN Ste a
Seneca, SC 29678-1156

Mailing address

430 Kingston Trace Rd
Columbia, SC 29229-7691
Phone (218) 576-9867

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250715003756 SC Practitioner - Nurse Practitioner 0648785923 Reassigns benefits to 2 organizations
I20260204002065 MN Practitioner - Nurse Practitioner 0648785923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Danielle Golden, Crna, PAGroup PAC ID 6305934597, 30 clinicians
Taral Sharma MD PCGroup PAC ID 0244568152, 27 clinicians

Practice addresses (Care Compare)

14551 Judicial Rd
Burnsville, MN 55306-4841
Phone (952) 431-5330

201 Central Park LN
Seneca, SC 29678-1156
Phone (864) 844-9432

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
12749MNMDPhysical Therapist
30234SCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Taral Sharma MD PC CurrentSince Jun 1, 2005 Accepting new patients
Danielle Golden, Crna, PA CurrentSince Jan 1, 2026 Accepting new patients
Essential Psychiatry and Wellness Psychiatric/Mental Health CurrentSince May 1, 2026 Accepting new patients

Locations

14551 Judicial Rd
Burnsville, MN 55306
Phone 9528985020 ext. 129

14551 Judicial Rd
Ste 300
Burnsville, MN 55306

3555 Willow Lake Blvd
Ste 290
Vadnais Heights, MN 55110

3640 Talmage Cir
Ste 216
Vadnais Hts, MN 55110
Phone (651) 379-4006

10 Financial Blvd
Anderson, SC 29621
Phone (855) 663-7772

120 Pelham Ln
Anderson, SC 29621
Phone (864) 627-5337

201 Central Park Ln
Seneca, SC 29678
Phone (844) 864-9432

201 Central Park Ln
Ste A
Seneca, SC 29678
Phone (864) 844-9432

203 Central Park Ln
Seneca, SC 29678
Phone (864) 844-9432

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1750982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1144118084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 KINGSTON TRACE RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292297691",
            "telephone_number": "218-576-9867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 CENTRAL PARK LN STE A",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296781156",
            "telephone_number": "864-844-9432",
            "fax_number": "864-844-9430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRUI",
        "first_name": "JOHN",
        "middle_name": "KIBET",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-27",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "12749",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "30234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca, SC

Sources for this page

Verify at the official NPI Registry.