Individual provider Active NPI

Karen Leanne Wickliffe-Keisler, M.D.

  • Ophthalmology Physician
  • Boiling Springs, SC
National Provider Identifier
1235333634
Registry record updated Jul 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD29782 Issued in SC
Practice address
1520 Boiling Springs Rd
Boiling Springs, SC 29316
Phone
(864) 583-6381
Fax
(864) 583-6390
NPI assigned
Jun 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X LL29782 SC
Ophthalmology Physician 207W00000X MD29782 SC Primary

Addresses

Primary practice location

1520 Boiling Springs Rd
Boiling Springs, SC 29316

Mailing address

479 Heywood Ave
Spartanburg, SC 29307-1726
Phone (864) 583-6381

Other practice location 1

479 Heywood Ave
Spartanburg, SC 29307-1726
Phone (864) 583-6381

Other identifiers 1

IdentifierTypeStateIssuer
7292OtherSCMEDICARE GROUP NUMBER

Other names 1

  • Ms. Karen Leanne Wickliffe Former name

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
I20110712000615 SC Practitioner - Ophthalmology 5991973224 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Medical University of South Carolina College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palmetto Eye and Laser Center LLCGroup PAC ID 1850317819, 6 clinicians

Practice addresses (Care Compare)

1520 Boiling Springs Rd
Boiling Springs, SC 29316-5121
Phone (864) 583-6381

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery551

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD29782SCMDOphthalmology Physician
LL29782SCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Specialty Eye Surgery, LLC CurrentSince Nov 24, 2020 Accepting new patients
Palmetto Eye & Laser Center, LLC Ophthalmology CurrentSince Aug 1, 2011 Accepting new patients

Locations

479 Heywood Ave
Spartanburg, SC 29307
Phone (864) 583-6381

1520 Boiling Springs Rd
Spartanburg, SC 29316
Phone (864) 583-6381

1530 Boiling Springs Rd
Spartanburg, SC 29316
Phone (864) 583-6381

Interoperability endpoints

  • Direct secure messaging: leanne.wickliffe@palmettoeyeandlaser.direct.eyemdemr.com

Organizations & group practices 2

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 4

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": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1235333634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "479 HEYWOOD AVE",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071726",
            "telephone_number": "864-583-6381",
            "fax_number": "864-583-6390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 BOILING SPRINGS RD",
            "city": "BOILING SPRINGS",
            "state": "SC",
            "postal_code": "29316",
            "telephone_number": "864-583-6381",
            "fax_number": "864-583-6390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "479 Heywood Ave",
            "address_purpose": "LOCATION",
            "city": "Spartanburg",
            "state": "SC",
            "postal_code": "293071726",
            "country_code": "US",
            "telephone_number": "864-583-6381",
            "fax_number": "864-583-6390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WICKLIFFE-KEISLER",
        "first_name": "KAREN",
        "middle_name": "LEANNE",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-12",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "LL29782",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "MD29782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "7292",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAREN",
            "last_name": "WICKLIFFE",
            "middle_name": "LEANNE",
            "prefix": "MS.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boiling Springs, SC

Sources for this page

Verify at the official NPI Registry.