Active NPI
Mary W Kayse, PNP
- Pediatric Nurse Practitioner
- Columbia, SC
National Provider Identifier
1326048349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- APN1242
- Practice address
- 4605 Monticello Rd
Columbia, SC 29203-4156 - Phone
- (803) 252-7001
- Fax
- (803) 252-5219
- NPI assigned
- Aug 1, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | APN1242 | SC | Primary |
Addresses
Primary practice location
4605 Monticello Rd
Columbia, SC 29203-4156
Mailing address
4605 Monticello Rd
Columbia, SC 29203-4156
Phone (803) 252-7001
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NP1795 | Medicaid | SC | |
| APN1242 | Other | SC | STATE LICENCE NUMBER |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1242 | SC | MD | Optometrist |
| APN1242 | SC | MD | Pediatric Nurse Practitioner |
Interoperability endpoints
- mary.kayse.1@10781.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306972800000",
"number": "1326048349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4605 MONTICELLO RD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292034156",
"telephone_number": "803-252-7001",
"fax_number": "803-252-5219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4605 MONTICELLO RD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292034156",
"telephone_number": "803-252-7001",
"fax_number": "803-252-5219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAYSE",
"first_name": "MARY",
"middle_name": "W",
"credential": "PNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-01",
"last_updated": "2011-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "SC",
"license": "APN1242",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NP1795",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENCE NUMBER",
"identifier": "APN1242",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.