Individual provider Active NPI

Harley Addison Kennington

  • Nurse Practitioner
  • Lancaster, SC
National Provider Identifier
1366269797
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
30169 Issued in SC
Practice address
1025 W Meeting St Ste 200
Lancaster, SC 29720-2246
Phone
(803) 285-7414
Fax
(803) 283-4329
NPI assigned
Sep 25, 2024
Last updated
Mar 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 30169 SC Primary

Addresses

Primary practice location

1025 W Meeting St Ste 200
Lancaster, SC 29720-2246

Mailing address

1025 W Meeting St Ste 200
Lancaster, SC 29720-2246
Phone (803) 285-7414

Other practice location 1

8351 Charlotte Hwy Ste 200
Indian Land, SC 29707-6553
Phone (803) 285-7414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250815002551 SC Practitioner - Nurse Practitioner 7315446481 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Carolina School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Liberty Doctors LLCGroup PAC ID 0840466017, 44 clinicians

Practice addresses (Care Compare)

1025 W Meeting St
Suite 200
Lancaster, SC 29720-2246
Phone (803) 285-7414

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mackey Family Practice, PA Nurse Practitioner CurrentSince May 5, 2025 Accepting new patients
Liberty Doctors, LLC CurrentSince Mar 1, 2026 Accepting new patients
Liberty Doctors LLC CurrentSince Mar 1, 2026 Accepting new patients
Liberty Doctors LLC Past Accepting new patients

Locations

418 Folly Rd
#A
Charleston, SC 29412
Phone (843) 225-8320

8351 Charlotte Hwy
Ste 200
Indian Land, SC 29707
Phone (803) 285-1082

1025 W Meeting St
Ste 200
Lancaster, SC 29720
Phone (803) 285-1082

Organizations & group practices 4

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 1

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": "1727222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1366269797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 W MEETING ST STE 200",
            "city": "LANCASTER",
            "state": "SC",
            "postal_code": "297202246",
            "telephone_number": "803-285-7414",
            "fax_number": "803-283-4329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 W MEETING ST STE 200",
            "city": "LANCASTER",
            "state": "SC",
            "postal_code": "297202246",
            "telephone_number": "803-285-7414",
            "fax_number": "803-283-4329"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8351 Charlotte Hwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Indian Land",
            "state": "SC",
            "postal_code": "297076553",
            "country_code": "US",
            "telephone_number": "803-285-7414",
            "fax_number": "803-283-4329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNINGTON",
        "first_name": "HARLEY",
        "middle_name": "ADDISON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-25",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "30169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, SC

Sources for this page

Verify at the official NPI Registry.