Kendall Dorie
Individual provider Active NPI Family Nurse Practitioner · Piedmont, SC
NPI 1164081253 · NPPES record last updated Jul 28, 2021
Key facts
- NPI
- 1164081253
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 23300 (SC)
- Practice address
- 206 Wall St
Piedmont, SC 29673-6754 - Phone
- (864) 269-7950
- NPI assigned
- Jun 12, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
- Dr William M Scott, Mdvip PA
Practice addresses (Care Compare)
206 Wall St
Piedmont, SC 29673-6754
Phone (864) 269-7950
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200513000748 | SC | Practitioner - Nurse Practitioner | 3678904349 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23300 | SC | MD | Pediatric Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Addictionology Associates LLC | Family | Current | Accepting new patients |
| Addictionology Associates LLC | Current |
Accepting new patients | |
| Dr William M Scott, Mdvip PA | Current |
Accepting new patients |
Locations
206 Wall St
Ste 1
Piedmont, SC 29673
Phone (864) 269-7950
206 Wall St
Powdersville, SC 29673
Phone (864) 269-7950
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 23300 | SC | Yes |
Addresses
Primary practice location
206 Wall St
Piedmont, SC 29673-6754
Mailing address
206 Wall St
Piedmont, SC 29673-6754
Phone (864) 269-7950
Other providers in Piedmont, SC
- Dhruv 1 LLC
- Rachel Wilson Dillman
- Divine Purpose Home Healthcare, LLC
- Melissa Conley Dodaro
- Makencie Donald
- Dosher Physical Therapy Associates
- Christine Dowling
- Dr William M Scott, Mdvip PA
- E Z Access Pharmacy Inc
- Susan G Eades
All providers in Piedmont, SC · Family Nurse Practitioner in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.