Individual provider Active NPI

Mary Kathryn C West, APRN

  • Nurse Practitioner
  • Pickens, SC
National Provider Identifier
1306323977
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
21991 Issued in SC
Practice address
716 E Cedar Rock St
Pickens, SC 29671-2324
Phone
(864) 878-4739
NPI assigned
Jul 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 21991 SC Primary

Addresses

Primary practice location

716 E Cedar Rock St
Pickens, SC 29671-2324

Mailing address

716 E Cedar Rock St
Pickens, SC 29671-2324
Phone (610) 905-5888

Other identifiers 1

IdentifierTypeStateIssuer
NP5881MedicaidSC

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190312003256 SC Practitioner - Nurse Practitioner 8022358944 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
21991SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Longevity Clinical LTC Associates of South Carolina, PC CurrentSince Mar 18, 2024 Accepting new patients
SC House Calls Inc CurrentSince Feb 25, 2019 Accepting new patients
Psgsc MSSP, P.C. CurrentSince Jul 24, 2025 Accepting new patients
SC House Calls Inc CurrentSince Feb 25, 2019 Accepting new patients
Careconnectmd South Carolina P.C. CurrentSince Jun 27, 2025 Accepting new patients
Physicians Services Group, P.C. CurrentSince Jun 9, 2025 Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

611 E Hampton St
Anderson, SC 29624
Phone (864) 226-5054

1624 Main St
Columbia, SC 29201
Phone (803) 454-0365

111 Doctor Cir
Columbia, SC 29203
Phone (803) 730-8910

8595 Pelham Rd
Ste 400
Greenville, SC 29615
Phone (864) 316-8984

2 Griffith Rd
Greenville, SC 29607
Phone (864) 276-8583

1240 Winnowing Way
Unit 102
Mt Pleasant, SC 29466
Phone (828) 396-5634

1053 Center St
West Columbia, SC 29169
Phone (803) 454-0365

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1532476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1306323977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 E CEDAR ROCK ST",
            "city": "PICKENS",
            "state": "SC",
            "postal_code": "296712324",
            "telephone_number": "610-905-5888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 E CEDAR ROCK ST",
            "city": "PICKENS",
            "state": "SC",
            "postal_code": "296712324",
            "telephone_number": "864-878-4739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEST",
        "first_name": "MARY KATHRYN",
        "middle_name": "C",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-25",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "21991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP5881",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pickens, SC

Sources for this page

Verify at the official NPI Registry.