NPIMap

Individual provider Active NPI

Kyle Ernest Watford, MD

  • Orthopaedic Trauma Physician
  • Seneca, SC
National Provider Identifier
1225000573
Registry record updated Aug 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X
License
20275 Issued in SC
Practice address
10630 Clemson Blvd Ste 100
Seneca, SC 29678-4545
Phone
(864) 482-6000
NPI assigned
Feb 2, 2006
Last updated
Aug 31, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 20275 SC
Orthopaedic Trauma Physician 207XX0801X 20275 SC Primary

Addresses

Primary practice location

10630 Clemson Blvd Ste 100
Seneca, SC 29678-4545

Mailing address

1 Independence Pointe
Suite 212
Greenville, SC 29615-4536
Phone (864) 797-6328

Other identifiers 8

IdentifierTypeStateIssuer
20072627OtherSCSELECT HEALTH
H640278552OtherSCMEDICARE PTAN
206186OtherSCMEDCOST
8000830OtherSCCIGNA
055OtherSCBCBS
5909037OtherNCNC MEDICAID
202756MedicaidSC
7574373OtherSCAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040708001206 SC Practitioner - Orthopedic Surgery 4385622166 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Medical University of South Carolina College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Saint Francis Dr
Greenville, SC 29601-3955
Phone (513) 853-8520

1050 Grove Rd
Greenville, SC 29605-4649
Phone (864) 234-7654

10630 Clemson Blvd
Suite 100
Seneca, SC 29678-4545
Phone (864) 482-6000

3 Saint Francis Dr
Greenville, SC 29601-3972

317 Saint Francis Dr
Suite 220
Greenville, SC 29601-3976
Phone (864) 255-1901

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Sep 11, 2017 Accepting new patients
Prisma Health University Medical Group CurrentSince Sep 11, 2017 Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC Orthopaedic Surgery CurrentSince May 21, 2022 Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC Orthopaedic Surgery CurrentSince May 21, 2022 Accepting new patients
St Francis Physician Services Inc CurrentSince Dec 1, 2019 Accepting new patients
St Francis Physician Services Inc Orthopaedic Surgery CurrentSince Dec 1, 2019 Accepting new patients
St Francis Physician Services Inc Orthopaedic Surgery Past Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

1200 Brookfield Blvd
Ste 400B
Greenville, SC 29607
Phone (864) 605-3721

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

317 Saint Francis Dr
Ste 220
Greenville, SC 29601
Phone (864) 255-1901

10630 Clemson Blvd
Ste 100
Seneca, SC 29678
Phone (864) 260-9910

Interoperability endpoints

  • Direct secure messaging: kwatford@cocpc1960.srs-direct.com

Organizations & group practices 7

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.

Hospital & facility affiliations 11

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": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504137600000",
    "number": "1225000573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE POINTE",
            "address_2": "SUITE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154536",
            "telephone_number": "864-797-6328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10630 CLEMSON BLVD STE 100",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296784545",
            "telephone_number": "864-482-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATFORD",
        "first_name": "KYLE",
        "middle_name": "ERNEST",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2017-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "SC",
            "license": "20275",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "SC",
            "license": "20275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT HEALTH",
            "identifier": "20072627",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "H640278552",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "206186",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8000830",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "055",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC MEDICAID",
            "identifier": "5909037",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202756",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7574373",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca, SC

Sources for this page

Verify at the official NPI Registry.