Kaylie Marie Stamco

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4185 Issued in SC

Practice address

1847 S Lake Dr
Lexington, SC 29073-7759

Phone

(803) 356-8998

NPI assigned

Oct 31, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OH, NC, SC3 enrollments

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 3

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Urgent Cares LLCGroup PAC ID 8628502598, 183 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Novant Health Urgent Cares LLC

  • Urgent Care Clinic/Center
  • Anderson, SC
  • NPI 1841026382
  Medicare reassignment Care Compare group
• Caromont Medical Group Inc

  • Family Medicine Physician
  • Gastonia, NC
  • NPI 1356314272

  Single Specialty

  Medicare reassignment NPD
• Greater Toledo Urgent Cares, LLC.

  • Emergency Medicine Physician
  • Toledo, OH
  • NPI 1982993010

  Single Specialty

  Medicare reassignment NPD
• Caromont Medical Group Inc

  • Family Medicine Physician
  • Stanley, NC
  • NPI 1972301380
  NPD
• West Toledo Urgent Care LLC

  • Urgent Care Clinic/Center
  • Toledo, OH
  • NPI 1952708000

  Single Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1245707942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749306",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1847 S LAKE DR",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290737759",
            "telephone_number": "803-356-8998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "609 Eastpointe Ct",
            "address_purpose": "LOCATION",
            "city": "Amherst",
            "state": "OH",
            "postal_code": "44001",
            "country_code": "US",
            "telephone_number": "440-610-7963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAMCO",
        "first_name": "KAYLIE",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-31",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.006498RX",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC PA LICENSE",
            "identifier": "4185",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC PA LICENSE",
            "identifier": "0010-11220",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE #",
            "identifier": "50.006498RX",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Myers Sprouse, MSW, LISW-CP
• Shannon Spry, OT
• St. Andrews Surgical Assoc. PC
• Kaytlin Stackpole, MRC
• Clifford D Staggs, MD
• Kerri Stanford, MSP CCC-SLP
• Elisa Randi Stanley, LMT
• Fiona Stanton
• Pamela Pendleton Staples, MS (CCC-SLP)
• Kelsi D Starks-Brice

• Physician Assistant in Lexington, SC
• Providers in Lexington, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.