Individual provider Active NPI

Keith Matthews, R.PH.

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Edgefield, SC
National Provider Identifier
1306356993
Registry record updated Oct 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
9414 Issued in SC
Practice address
100 Ridge Medical Plaza Rd Ste 101
Edgefield, SC 29824-4556
Phone
(803) 637-5757
Fax
(803) 637-9996
NPI assigned
Oct 9, 2017
Last updated
Oct 9, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 9414 SC
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 9414 SC Primary

Addresses

Primary practice location

100 Ridge Medical Plaza Rd Ste 101
Edgefield, SC 29824-4556

Mailing address

100 Ridge Medical Plaza Rd Ste 101
Edgefield, SC 29824-4556
Phone (803) 637-5757

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
9414SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Banks Pharmacy Current Accepting new patients

Locations

100 Ridge Medical Plaza Rd
Ste 101
Edgefield, SC 29824
Phone (803) 637-5757

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1507507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507507200000",
    "number": "1306356993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RIDGE MEDICAL PLAZA RD STE 101",
            "city": "EDGEFIELD",
            "state": "SC",
            "postal_code": "298244556",
            "telephone_number": "803-637-5757",
            "fax_number": "803-637-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RIDGE MEDICAL PLAZA RD STE 101",
            "city": "EDGEFIELD",
            "state": "SC",
            "postal_code": "298244556",
            "telephone_number": "803-637-5757",
            "fax_number": "803-637-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "KEITH",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-09",
        "last_updated": "2017-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "9414",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "SC",
            "license": "9414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgefield, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2017; 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.