Kirsten Blythe Carlson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4288 Issued in SC

Practice address

1304 W Bobo Newsom Hwy
Hartsville, SC 29550-4710

Phone

(843) 339-2100

NPI assigned

Nov 4, 2021

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

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

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

97.83

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: kcarlson97098@directmcleodehealth.org

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.

• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555
  Medicare reassignment
• App of South Carolina Ed PLLC

  • Emergency Medicine Physician
  • Hartsville, SC
  • NPI 1457878084
  Medicare reassignment
• Ies South Carolina LLC

  • Emergency Medicine Physician
  • Hartsville, SC
  • NPI 1821779695
  Medicare reassignment

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

{
    "created_epoch": "1635984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1437814480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 ASCOT DR",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295011913",
            "telephone_number": "240-539-4292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 W BOBO NEWSOM HWY",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295504710",
            "telephone_number": "843-339-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "KIRSTEN",
        "middle_name": "BLYTHE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-04",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caresouth
• Caresouth Carolina, Inc.
• Caresouth Carolina, Inc.
• Caresouth Carolina, Inc. (CareFusion)
• Caring Hearts Pediatrics
• Carolina Family Practice P a
• Carolina Mobility of Hartsville LLC (Carolina Mobility of Hartsville)
• Carolina Nephrology and Endocrinology, PC
• Carriage House Senior Living of Hartsville
• Shari K Carter, FNP

• Physician Assistant in Hartsville, SC
• Providers in Hartsville, 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 Feb 28, 2022; 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.