Stephanie King, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

21133 Issued in SC

Practice address

5269 Calhoun Memorial Hwy
Easley, SC 29640-3865

Phone

(866) 389-2727

Fax

(864) 306-7615

NPI assigned

Jul 29, 2017

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1501286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1407370620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5269 CALHOUN MEMORIAL HWY",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296403865",
            "telephone_number": "866-389-2727",
            "fax_number": "864-306-7615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5269 CALHOUN MEMORIAL HWY",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296403865",
            "telephone_number": "866-389-2727",
            "fax_number": "864-306-7615"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "224 E Butler Rd",
            "address_purpose": "LOCATION",
            "city": "Mauldin",
            "state": "SC",
            "postal_code": "296622129",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "STEPHANIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-29",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "21133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP4640",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kellys Family Pharmacy
• Mary Ann Ketterman
• Olivia Khalil, PHARMD
• Amol Arvind Kheur
• Charles Phillip King Jr., DMD, MS
• Kingdom Deliverance Ministries
• William S Koch, M.D.
• Elliot Nash Konrade, MD
• Alessandra Annaliza Korber, LISW-CP
• Austin Krantz

• Family Nurse Practitioner in Easley, SC
• Providers in Easley, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.