Individual provider Active NPI

Brittany Kelly, MD

  • Student in an Organized Health Care Education/Training Program
  • West Columbia, SC
National Provider Identifier
1295585602
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
145 Sunset CT Ste 100
West Columbia, SC 29169-2429
Phone
(803) 739-3550
Fax
(803) 739-3546
NPI assigned
Mar 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

145 Sunset CT Ste 100
West Columbia, SC 29169-2429

Mailing address

126 Laurel Crossing Dr
Lugoff, SC 29078-9194
Phone (803) 608-7656

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bkelly175572@direct.lexmed.com

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
I20241023004306 SC Order and Referring Only - Family PracticePractitioner - Family Practice 9335672740

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1711411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1295585602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 LAUREL CROSSING DR",
            "city": "LUGOFF",
            "state": "SC",
            "postal_code": "290789194",
            "telephone_number": "803-608-7656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 SUNSET CT STE 100",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291692429",
            "telephone_number": "803-739-3550",
            "fax_number": "803-739-3546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "BRITTANY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-26",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bkelly175572@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "145 Sunset Ct Ste 100",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291692429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

Verify at the official NPI Registry.