NPIMap

Individual provider Active NPI

Keith T Borg, MD

  • Emergency Medicine Physician
  • Charleston, SC
National Provider Identifier
1316042518
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
10737A Issued in WY
Practice address
171 Ashley Ave
Charleston, SC 29425-0001
Phone
(843) 792-1414
NPI assigned
Sep 13, 2006
Last updated
Jan 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X TL29317 SC
Emergency Medicine Physician 207P00000X 10737A WY Primary

Addresses

Primary practice location

171 Ashley Ave
Charleston, SC 29425-0001

Mailing address

PO Box 751461
Charlotte, NC 28275-1461
Phone (843) 792-6200

Other practice location 1

1401 W 5th St
Sheridan, WY 82801-2705
Phone (307) 672-1100

Other identifiers 1

IdentifierTypeStateIssuer
293177MedicaidSC

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kborg20136@direct.musc.edu Direct
Direct Messaging Address kborg@sheridan.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, WY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060925000238 SC Practitioner - Pediatric MedicinePractitioner - Internal MedicinePractitioner - Emergency Medicine 6901798578 Reassigns benefits to 1 organization
I20161027000905 WY Practitioner - Emergency Medicine 6901798578 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Emergency Medicine, Internal Medicine
Education
Medical University of South Carolina College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.21 of 100Reported as group
Quality
80.49
Promoting interoperability
94
Improvement activities
40
Cost
68.55

Merit-based Incentive Payment System (MIPS)

Final score
79.02 of 100Reported as group
Quality
62.41
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TL29317SCMDEmergency Medicine Physician
10737AWYMDEmergency Medicine Physician
29317SCMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol Current Accepting new patients
University Medical Associates of the Medical University of South Carol Emergency Medicine CurrentSince Sep 6, 2006 Accepting new patients
Northwest Emergency Physicians LLC Emergency Medicine CurrentSince Dec 1, 2016 Accepting new patients
North Lincoln County Hospital District CurrentSince Oct 7, 2024 Accepting new patients
Memorial Hospital of Converse County CurrentSince Dec 1, 2019 Accepting new patients
North Lincoln County Hospital District CurrentSince Oct 7, 2024 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Sep 6, 2006 Accepting new patients
Grady Memorial Hospital Corporation Past Accepting new patients

Locations

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

901 Adams St
Afton, WY 83110
Phone (307) 885-5800

111 S 5th St
Douglas, WY 82633
Phone (307) 358-6200

2100 W Sunset Dr
Riverton, WY 82501
Phone (307) 856-4161

Interoperability endpoints

  • Direct secure messaging: kborg@sheridan.cernerdirect.com
  • Direct secure messaging: kborg20136@direct.musc.edu

Organizations & group practices 9

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1316042518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294250001",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 W 5th St",
            "address_purpose": "LOCATION",
            "city": "Sheridan",
            "state": "WY",
            "postal_code": "828012705",
            "country_code": "US",
            "telephone_number": "307-672-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORG",
        "first_name": "KEITH",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "TL29317",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WY",
            "license": "10737A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "293177",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kborg20136@direct.musc.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "171 Ashley Ave",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294250001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kborg@sheridan.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1401 W 5th St",
            "city": "Sheridan",
            "state": "WY",
            "country_code": "US",
            "postal_code": "828012705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.