Kathleen Ann O'Leary, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

24236 Issued in SC

Practice address

164 Waccamaw Medical Park Dr
Conway, SC 29526-8903

Phone

(843) 347-5060

NPI assigned

Nov 6, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• South Carolina Dept of Mental Health Accounting Office

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Conway, SC
  • NPI 1356397228
  Medicare reassignment NPD
• South Carolina Dept of Mental Health Accounting Office

  • Psychiatric Hospital
  • Anderson, SC
  • NPI 1376595041

  Psychiatry

  Medicare reassignment NPD
• South Carolina Dept of Mental Health Accounting Office

  • Community/Behavioral Health Agency
  • Columbia, SC
  • NPI 1083421994
  NPD
• Pineland Area Community Services Board

  • Community/Behavioral Health Agency
  • Statesboro, GA
  • NPI 1588735252
  NPD (past)

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1366521684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 LAFAYETTE CIR",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294402569",
            "telephone_number": "843-546-6107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 WACCAMAW MEDICAL PARK DR",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295268903",
            "telephone_number": "843-347-5060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'LEARY",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "055412",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "24236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "327877",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nye'S Pharmacy Inc.
• Nye'S Pharmacy Inc.
• Nye'S Pharmacy of Conway,Inc.
• Nyes Pharmacy of Conway Inc
• Thomas John O'Connor, FNP
• Tami Gail Obranovic, RN
• Occ Doc of South Carolina
• Micheal A Odle, MD
• Bradley Wayne Odom, BS-HIS
• Joseph Hamilton Odom, R.PH

• Psychiatry Physician in Conway, SC
• Providers in Conway, SC by specialty
• Psychiatry Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.