Individual provider Active NPI

Mary W Kayse, PNP

  • Pediatric Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1326048349
Registry record updated Jun 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APN1242 Issued in SC
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

Updated by the provider on Jun 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
NP1795MedicaidSC
APN1242OtherSCSTATE 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

LicenseStateTypeSpecialty
1242SCMDOptometrist
APN1242SCMDPediatric Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: 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.

Verify at the official NPI Registry.