Individual provider Active NPI

Thomas Lester Klvana, PA

  • Physician Assistant
  • Manning, SC
National Provider Identifier
1376859470
Registry record updated Nov 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
TL 1546 Issued in SC
Practice address
10 E Hospital St
Hospitalist Department
Manning, SC 29102-3153
Phone
(803) 435-8463
Fax
(803) 435-5288
NPI assigned
Aug 26, 2010
Last updated
Nov 19, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2014

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 TL 1546 SC Primary

Addresses

Primary practice location

10 E Hospital St
Hospitalist Department
Manning, SC 29102-3153

Mailing address

10 E Hospital St
Hospitalist Department
Manning, SC 29102-3153
Phone (803) 435-8463

Other identifiers 1

IdentifierTypeStateIssuer
TL 1546OtherSCPA LICENSE

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
I20110222000254 SC Practitioner - Physician Assistant 1557542768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLeod Health ClarendonGroup PAC ID 0840582656, 60 clinicians

Practice addresses (Care Compare)

10 E Hospital St
Manning, SC 29102-3153
Phone (803) 435-8463

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1546SCMDCounselor
TL 1546SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Health Clarendon CurrentSince Apr 1, 2017 Accepting new patients
McLeod Health Clarendon CurrentSince Apr 1, 2017 Accepting new patients

Locations

10 E Hospital St
Manning, SC 29102
Phone (803) 433-3000

200 E Hospital St
Manning, SC 29102
Phone (803) 433-0439

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 2

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": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416355200000",
    "number": "1376859470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 E HOSPITAL ST",
            "address_2": "HOSPITALIST DEPARTMENT",
            "city": "MANNING",
            "state": "SC",
            "postal_code": "291023153",
            "telephone_number": "803-435-8463",
            "fax_number": "803-435-5288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 E HOSPITAL ST",
            "address_2": "HOSPITALIST DEPARTMENT",
            "city": "MANNING",
            "state": "SC",
            "postal_code": "291023153",
            "telephone_number": "803-435-8463",
            "fax_number": "803-435-5288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLVANA",
        "first_name": "THOMAS",
        "middle_name": "LESTER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-26",
        "last_updated": "2014-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "TL 1546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "TL 1546",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manning, SC

Sources for this page

Verify at the official NPI Registry.