Individual provider Active NPI

Kevin L Cromer, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Spartanburg, SC
National Provider Identifier
1184256174
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
23766 Issued in SC
Practice address
104 N Daniel Morgan Ave Ste 105
Spartanburg, SC 29306-2363
Phone
(864) 365-2729
Fax
(864) 383-5093
NPI assigned
Feb 7, 2020
Last updated
Sep 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 23766 SC Primary

Addresses

Primary practice location

104 N Daniel Morgan Ave Ste 105
Spartanburg, SC 29306-2363

Mailing address

104 N Daniel Morgan Ave Ste 105
Spartanburg, SC 29306-2363
Phone (864) 365-2729

Other identifiers 1

IdentifierTypeStateIssuer
NP6706MedicaidSC

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
I20220517002467 SC Practitioner - Psychiatry 3173952439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Upstate Mental Health, LLCGroup PAC ID 9739566548, 3 clinicians

Practice addresses (Care Compare)

104 N Daniel Morgan Ave
Suite 105
Spartanburg, SC 29306-2363
Phone (864) 365-2729

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23766SCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Mental Health, LLC CurrentSince Mar 29, 2022 Accepting new patients

Locations

104 N Daniel Morgan Ave
Ste 105
Spartanburg, SC 29306
Phone (864) 365-2729

Organizations & group practices 1

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": "1581033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1184256174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 N DANIEL MORGAN AVE STE 105",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293062363",
            "telephone_number": "864-365-2729",
            "fax_number": "864-383-5093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 N DANIEL MORGAN AVE STE 105",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293062363",
            "telephone_number": "864-365-2729",
            "fax_number": "864-383-5093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROMER",
        "first_name": "KEVIN",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-07",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "23766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP6706",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.