Individual provider Active NPI

Kelly Lynn Driggers

  • Specialist
  • Mt Pleasant, SC
National Provider Identifier
1306102512
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
2505 Issued in SC
Practice address
3409 Salterbeck CT
Mt Pleasant, SC 29466-7117
Phone
(843) 761-1765
NPI assigned
Apr 2, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 2505 SC Primary

Addresses

Primary practice location

3409 Salterbeck CT
Mt Pleasant, SC 29466-7117

Mailing address

210 Shoreline LN
Moncks Corner, SC 29461-8073
Phone (843) 761-1765

Other names 1

  • Kelly Lynn Driggers Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2505SCMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333324800000",
    "number": "1306102512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 SHORELINE LN",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294618073",
            "telephone_number": "843-761-1765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3409 SALTERBECK CT",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294667117",
            "telephone_number": "843-761-1765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRIGGERS",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-02",
        "last_updated": "2012-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "SC",
            "license": "2505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "DRIGGERS",
            "middle_name": "LYNN",
            "credential": "COTA/L",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Mt Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.