Individual provider Active NPI

Kelly Anne Truesdale, D.O.

  • Family Medicine Physician
  • Columbia, SC
National Provider Identifier
1154618882
Registry record updated Jan 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
83843 Issued in SC
Practice address
7033 Saint Andrews Rd
Columbia, SC 29212-1179
Phone
(803) 732-0963
Fax
(803) 732-1406
NPI assigned
Jul 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OP60524953 WA
Family Medicine Physician 207Q00000X 8612 SD
Family Medicine Physician 207Q00000X 83843 SC Primary

Addresses

Primary practice location

7033 Saint Andrews Rd
Columbia, SC 29212-1179

Mailing address

PO Box 6069
West Columbia, SC 29171-6069
Phone (803) 732-0963

Other practice location 1

21 NE Romance Hill Rd
Belfair, WA 98528-8315
Phone (360) 277-2975

Other identifiers 1

IdentifierTypeStateIssuer
2044716MedicaidWA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ktruesdale120019@fhsce.catholichealth.net Direct
Direct Messaging Address ktruesdale159573@direct.lexmed.com

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221126000070 SC Practitioner - Family Practice 2769634401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia Col of Osteo Med, Sewanee, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lexington Health IncGroup PAC ID 2567872070, 905 clinicians

Practice addresses (Care Compare)

7037 Saint Andrews Rd
Columbia, SC 29212-1177
Phone (803) 732-0963

Hospital & facility affiliations

  • Amedisys Home Health of Lexington Home health agency, Lexington, SC, CCN 427039
  • Lexington Medical Center Hospital, West Columbia, SC, CCN 420073

Merit-based Incentive Payment System (MIPS)

Final score
84.09 of 100Reported as group
Quality
68.87
Promoting interoperability
100
Improvement activities
40
Cost
78.11

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington Health Inc Family Medicine CurrentSince Jan 1, 2023 Accepting new patients
Lexington County Health Services District Inc Current Accepting new patients
Lexington Health Inc CurrentSince Jan 1, 2023 Accepting new patients
Lexington Health Inc Family Medicine Current Accepting new patients
Lexington County Health Services District, Inc. Past Accepting new patients

Locations

7037 Saint Andrews Rd
Columbia, SC 29212
Phone (803) 732-0963

811 W Main St
Ste 101
Lexington, SC 29072
Phone (803) 936-7230

Interoperability endpoints

  • Direct secure messaging: ktruesdale159573@direct.lexmed.com
  • Direct secure messaging: ktruesdale120019@fhsce.catholichealth.net

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1154618882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6069",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291716069",
            "telephone_number": "803-732-0963",
            "fax_number": "803-732-1406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7033 SAINT ANDREWS RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292121179",
            "telephone_number": "803-732-0963",
            "fax_number": "803-732-1406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 NE Romance Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Belfair",
            "state": "WA",
            "postal_code": "985288315",
            "country_code": "US",
            "telephone_number": "360-277-2975",
            "fax_number": "360-782-3244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRUESDALE",
        "first_name": "KELLY",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-01",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP60524953",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "8612",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "83843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2044716",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ktruesdale120019@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "21 NE Romance Hill Rd",
            "city": "Belfair",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985288315",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ktruesdale159573@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "7033 Saint Andrews Rd",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292121179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.