Nicole C Keeter, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

TL3251 Issued in SC

Practice address

1700 1St Baxter Xing Ste 101
Fort Mill, SC 29708-8950

Phone

(803) 802-3376

Fax

(803) 802-3329

NPI assigned

Oct 13, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

George Washington University School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Dermatology of SC PCGroup PAC ID 4284864372, 32 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

83.24 of 100Reported as group

Quality

80.28

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Advanced Dermatology of SC PC

  • Dermatology Physician
  • Spartanburg, SC
  • NPI 1255754008
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1223856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1396997110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 1ST BAXTER XING STE 101",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088950",
            "telephone_number": "803-802-3376",
            "fax_number": "803-802-3329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 1ST BAXTER XING STE 101",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088950",
            "telephone_number": "803-802-3376",
            "fax_number": "803-802-3329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEETER",
        "first_name": "NICOLE",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-13",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110003081",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DC",
            "license": "PA030560",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "TL3251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Marie Kasik, DC, MS
• Katie L Macken DDS LLC (Orchard Grove Family Dentistry)
• Dana Marie Katulak, AUD
• Kaycee Hair
• Laura Kearns, RBT
• Alaina Kemp
• Ebony P. Kennedy, M.ED., LPC
• Tyler Kent
• Whitney Nicole Kersey, FNP-BC
• Joel Carlton Key, PHARM.D

• Physician Assistant in Fort Mill, SC
• Providers in Fort Mill, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; 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.