Irakli Khulordava, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

29322 Issued in SC

Practice address

819 N Fant St
Anderson, SC 29621-5717

Phone

(864) 261-1800

Fax

(864) 261-1856

NPI assigned

Oct 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Internal MedicineAlso: Infectious Disease

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anmed HealthGroup PAC ID 1951215243, shared by 12 NPIs, 348 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Anmed Health Hospital, Anderson, SC, CCN 420027
• Cannon Memorial Hospital Hospital, Pickens, SC, CCN 420011

Merit-based Incentive Payment System (MIPS)

Final score

94.7 of 100Reported as apm

Quality

89.4

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ikhulordava9195@direct.anmedhealth.net

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.

• Anmed Health

  • Family Medicine Physician
  • Anderson, SC
  • NPI 1639102270
  Medicare reassignment NPD
• Anmed Health

  • Emergency Medicine Physician
  • Anderson, SC
  • NPI 1710918321
  Medicare reassignment NPD
• Anmed Health

  • Family Medicine Physician
  • Piedmont, SC
  • NPI 1255137832
  NPD
• Anmed Health

  • Infectious Disease Physician
  • Anderson, SC
  • NPI 1538192190
  NPD
• Diagnostic Radiology of Anderson, P.a.

  • Diagnostic Radiology Physician
  • Anderson, SC
  • NPI 1922125269
  NPD
• Piedmont Pathology Associates PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Anderson, SC
  • NPI 1235101965
  NPD
• Anmed Health

  • Gastroenterology Physician
  • Anderson, SC
  • NPI 1861761090
  NPD (past)
• Hospital Medicine Consultants of Anderson, LLC

  • Internal Medicine Physician
  • Anderson, SC
  • NPI 1932159639
  NPD (past)
• Dassee Community Health Systems

  • Critical Access Hospital
  • Blountstown, FL
  • NPI 1740285139
  NPD (past)
• Emcare Physician Providers, Inc.

  • Emergency Medicine Physician
  • Punta Gorda, FL
  • NPI 1376592063
  NPD (past)

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

• Anmed Health

  • General Acute Care Hospital
  • Anderson, SC
  • NPI 1417919531
  Care Compare affiliation
• Cannon Memorial Hospital

  • General Acute Care Hospital
  • Pickens, SC
  • NPI 1497744254
  Care Compare affiliation

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549497600000",
    "number": "1457433252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 N FANT ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296215717",
            "telephone_number": "864-261-1800",
            "fax_number": "864-261-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 N FANT ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296215717",
            "telephone_number": "864-261-1800",
            "fax_number": "864-261-1856"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "703 N Fant St Ste B",
            "address_purpose": "LOCATION",
            "city": "Anderson",
            "state": "SC",
            "postal_code": "296215705",
            "country_code": "US",
            "telephone_number": "864-512-4122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHULORDAVA",
        "first_name": "IRAKLI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2019-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "29322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "293220",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00137642",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie L. Kernaghan, O.T.
• Jill Eileen Kessler, FNP-BC
• Tanishia N Kessley
• Kevin Nietzer DMD PA
• Khizar Khan, MD
• Hui-Tzu M Kiang, DO
• Jared Mugabe Kiddoe, M.D.
• Alison Kill, OTR/L
• Amy L Kilpatrick
• Raymond Kimball, M.D.

• Internal Medicine Physician in Anderson, SC
• Providers in Anderson, SC by specialty
• Internal Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.