Kennah Johnson Brearley, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1865 Issued in SC

Practice address

3574 Sunset Blvd
West Columbia, SC 29169-3044

Phone

(803) 796-2500

NPI assigned

Nov 29, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Kennah Love Johnson Former name

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

Specialty

Physician Assistant

Education

University of Florida College of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolina Dermatology GRPGroup PAC ID 3274557384, 27 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

85.11 of 100Reported as group

Quality

84.56

Promoting interoperability

74

Improvement activities

40

Cost

87.49

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: kbrearley@cdgps.emadirect.md

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.

• Carolina Dermatology GRP

  • Dermatology Physician
  • Columbia, SC
  • NPI 1083693857
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1354147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367280000000",
    "number": "1285979435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3574 SUNSET BLVD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693044",
            "telephone_number": "803-796-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3574 SUNSET BLVD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693044",
            "telephone_number": "803-796-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREARLEY",
        "first_name": "KENNAH",
        "middle_name": "JOHNSON",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-29",
        "last_updated": "2013-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "1865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENNAH",
            "last_name": "JOHNSON",
            "middle_name": "LOVE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Corey Michael Brambley
• Lisa B Brannigan, NP
• Brantley W. Cope, DMD Dentistry, PA
• Ian Michael Brastauskas
• Bethany C Bray, M.D.
• William D. Brearley Jr., MD
• Chelsea Breen, DPT
• Michelle Kaitlin Breen, CNP
• William P Brehmer, M.D.
• Benjamin Breitbach, PHARMD

• Physician Assistant in West Columbia, SC
• Providers in West Columbia, 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 Apr 30, 2013; 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.