Janet M McKissick, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

13979 Issued in SC

Practice address

333 Revolutionary TRL
Fairfax, SC 29827-7109

Phone

(803) 632-2533

Fax

(803) 632-2451

NPI assigned

Jul 23, 2006

Sex

Female

Sole proprietor

No

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.

• Low Country Health Care System, Inc

  • Federally Qualified Health Center (FQHC)
  • Farifax, SC
  • NPI 1053475566

  SC

  Medicare reassignment NPD
• Low Country Health Care System, Inc

  • Federally Qualified Health Center (FQHC)
  • Bamberg, SC
  • NPI 1306378310

  SC

  Medicare reassignment NPD
• Low Country Health Care System, Inc

  • Federally Qualified Health Center (FQHC)
  • Barnwell, SC
  • NPI 1780112912

  SC

  Medicare reassignment NPD
• Low Country Health Care System, Inc

  • Federally Qualified Health Center (FQHC)
  • Williston, SC
  • NPI 1922468826
  NPD

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

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 27, 2023.

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1407878366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 MANOR VIEW CT",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292122330",
            "telephone_number": "803-603-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 REVOLUTIONARY TRL",
            "city": "FAIRFAX",
            "state": "SC",
            "postal_code": "298277109",
            "telephone_number": "803-632-2533",
            "fax_number": "803-632-2451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKISSICK",
        "first_name": "JANET",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-23",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "13979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139790",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "13979",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walter R Kirby, PA-C
• Mol Ky, DO
• Vicki Lynn Landis, WHNP-BC
• Low Country Health Care System, Inc
• Shenika L. Marshall-Hill
• Baxter McLendon, M.D.
• Myecha Lashawn Miley
• Mindshifters Solution LLC
• Tamatha Bowers Mixson, RN-BSN
• Marie Moore

• All providers in Fairfax, SC
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; 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.