Kelly Martin Wilson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1237 Issued in SC

Practice address

1330 Boiling Springs Rd
Suite 1600
Spartanburg, SC 29303-4201

Phone

(864) 582-6396

NPI assigned

Oct 13, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

University of South Carolina School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolina Orthopaedic and Neurosurgical AssociatesGroup PAC ID 5991695975, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Spartanburg Medical Center Hospital, Spartanburg, SC, CCN 420007

Merit-based Incentive Payment System (MIPS)

Final score

79.05 of 100Reported as group

Quality

68.98

Promoting interoperability

93

Improvement activities

40

Cost

67.04

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.wilson.pac.1@26879.direct.athenahealth.com

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.

• Carolina Orthopaedic and Neurosurgical Associates

  • Orthopaedic Surgery Physician
  • Spartanburg, SC
  • NPI 1568454056
  Medicare reassignment Care Compare group NPD
• Carolina Orthopaedic and Neurosurgical Associates

  • Orthopaedic Surgery Physician
  • Columbus, NC
  • NPI 1083309074
  NPD
• Carolina Lung Associates, PA

  • Pulmonary Disease Physician
  • Charleston, SC
  • NPI 1679562805
  NPD (past)
• Doctors Care, PA

  • Family Medicine Physician
  • Columbia, SC
  • NPI 1366499048
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Spartanburg Medical Center

  • Psychiatric Hospital Unit
  • Spartanburg, SC
  • NPI 1033681630
  Care Compare affiliation
• Spartanburg Medical Center

  • Family Medicine Physician
  • Spartanburg, SC
  • NPI 1326373697

  Hospital

  Care Compare affiliation
• Spartanburg Medical Center

  • General Acute Care Hospital
  • Spartanburg, SC
  • NPI 1609807122
  Care Compare affiliation
• Spartanburg Medical Center

  • Rehabilitation Hospital Unit
  • Spartanburg, SC
  • NPI 1942772546
  Care Compare affiliation

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

{
    "created_epoch": "1192233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352419200000",
    "number": "1396933461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 BOILING SPRINGS RD",
            "address_2": "SUITE 1600",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293034201",
            "telephone_number": "864-582-6396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 BOILING SPRINGS RD",
            "address_2": "SUITE 1600",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293034201",
            "telephone_number": "864-582-6396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KELLY",
        "middle_name": "MARTIN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-13",
        "last_updated": "2012-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "1237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0886PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dana Hope Wilson, NNP
• Evelyn Foster Wilson, EDD, MHS, NRP, NCEE
• Janet Leahy Wilson, PA-C
• Janet Monaco Wilson, O.D.
• John Roger Wilson III, CRNA
• Kimberly Susann Wilson, APRN
• Kristen Mabus Wilson, CNP
• Margaret Elizabeth Wilson, LPC
• Maria Wilson, PT
• Paula F Wilson, BA, CAC-P

• Medical Physician Assistant in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Medical Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.