NPIMap

Individual provider Active NPI

Kayla Peterson Tavernier

  • Physician Assistant
  • Abbeville, SC
National Provider Identifier
1346610524
Registry record updated Jan 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2419 Issued in SC
Practice address
901 W Greenwood St Ste 1
Abbeville, SC 29620-5727
Phone
(864) 366-9681
NPI assigned
Oct 1, 2015
Last updated
Jan 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2419 SC Primary

Addresses

Primary practice location

901 W Greenwood St Ste 1
Abbeville, SC 29620-5727

Mailing address

901 W Greenwood St
Suite 9
Abbeville, SC 29620-5717
Phone (864) 366-9681

Other names 1

  • Kayla P Tavernier Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160304001422 SC Practitioner - Physician Assistant 8022314889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical University of South Carolina College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

420 Thomson Cir
Abbeville, SC 29620-5656
Phone (864) 366-1649

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2419SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Abbeville County Memorial Hospital CurrentSince Dec 26, 2015 Accepting new patients
Abbeville County Memorial Hospital CurrentSince Dec 26, 2015 Accepting new patients

Locations

420 Thomson Cir
Abbeville, SC 29620
Phone (864) 366-1649

901 W Greenwood St
Abbeville, SC 29620
Phone (864) 459-5011

901 W Greenwood St
Ste 1
Abbeville, SC 29620
Phone (864) 229-2663

901 W Greenwood St
Ste 9
Abbeville, SC 29620
Phone (864) 366-9681

Interoperability endpoints

  • Direct secure messaging: ktavernier573415@selfregional.direct-ci.net

Organizations & group practices 3

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": "1443657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1346610524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W GREENWOOD ST",
            "address_2": "SUITE 9",
            "city": "ABBEVILLE",
            "state": "SC",
            "postal_code": "296205717",
            "telephone_number": "864-366-9681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W GREENWOOD ST STE 1",
            "city": "ABBEVILLE",
            "state": "SC",
            "postal_code": "296205727",
            "telephone_number": "864-366-9681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVERNIER",
        "first_name": "KAYLA",
        "middle_name": "PETERSON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-01",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "PA2419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLA",
            "last_name": "TAVERNIER",
            "middle_name": "P",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Abbeville, SC

Sources for this page

Verify at the official NPI Registry.