Individual provider Active NPI

Kimberly Dawn Powell, APRN, FNP-BC

  • Family Nurse Practitioner
  • Cheraw, SC
National Provider Identifier
1205326477
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
21885 Issued in SC
Practice address
721 Chesterfield Hwy
Cheraw, SC 29520-7002
Phone
(843) 320-5200
Fax
(843) 320-5002
NPI assigned
May 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 21885 SC Primary

Addresses

Primary practice location

721 Chesterfield Hwy
Cheraw, SC 29520-7002

Mailing address

805 Pamplico Hwy
Florence, SC 29505-6050
Phone (843) 674-6306

Other identifiers 1

IdentifierTypeStateIssuer
NP5844MedicaidSC

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190513001405 SC Practitioner - Nurse Practitioner 9335482447 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians

Practice addresses (Care Compare)

506 N St
Bamberg, SC 29003-1319
Phone (803) 245-6290

805 Pamplico Hwy
Florence, SC 29505-6047

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21885SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Family Care, Inc CurrentSince Oct 13, 2021 Accepting new patients
Carolina Family Care, Inc CurrentSince Oct 13, 2021 Accepting new patients
Musc Community Physicians Current Accepting new patients
Musc Community Physicians CurrentSince Jan 30, 2022 Accepting new patients
Musc Community Physicians CurrentSince Jan 30, 2022 Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

805 Pamplico Hwy
Florence, SC 29505
Phone (843) 674-2500

1341 Old Georgetown Rd
Ste C
Mt Pleasant, SC 29464
Phone (843) 884-2175

Interoperability endpoints

  • Direct secure messaging: kpowell253330@direct.musc.edu

Organizations & group practices 6

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 1

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": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1205326477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 PAMPLICO HWY",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295056050",
            "telephone_number": "843-674-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 CHESTERFIELD HWY",
            "city": "CHERAW",
            "state": "SC",
            "postal_code": "295207002",
            "telephone_number": "843-320-5200",
            "fax_number": "843-320-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-14",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "21885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP5844",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheraw, SC

Sources for this page

Verify at the official NPI Registry.