Individual provider Active NPI

Bruce J. Kowalski, M.D.

  • Cardiovascular Disease Physician
  • Burlington, NC
National Provider Identifier
1467479808
Registry record updated Jan 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
97-00624 Issued in NC
Practice address
1234 Huffman Mill Rd
Burlington, NC 27215-8700
Phone
(336) 538-1234
Fax
(336) 538-2390
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 97-00624 NC Primary

Addresses

Primary practice location

1234 Huffman Mill Rd
Burlington, NC 27215-8700

Mailing address

PO Box 1717
Burlington, NC 27216-1717
Phone (336) 538-1234

Other identifiers 1

IdentifierTypeStateIssuer
8910494MedicaidNC

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240424000222 SC Practitioner - Cardiovascular Disease (Cardiology) 5092602292 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 McLeod Health Blvd
Suite 201
Myrtle Beach, SC 29579-4477
Phone (843) 646-8001

107 McLeod Health Blvd
Myrtle Beach, SC 29579-4477

3485 Mitchell St
Loris, SC 29569-2823
Phone (843) 756-7029

3781 McDowell Lane
Suite 200
Little River, SC 29566-7833
Phone (843) 366-3891

3793 McDowell LN
Suite 200
Little River, SC 29566-7892
Phone (843) 390-0877

4000 Hwy 9 E
Suite 250
Little River, SC 29566-7833
Phone (843) 366-3891

555 E Cheves St
Florence, SC 29506-2617
Phone (843) 777-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
97-00624NCMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince Sep 15, 2024 Accepting new patients
Kernodle Clinic, Inc Current Accepting new patients
McLeod Physician Associates II CurrentSince Jan 9, 2024 Accepting new patients
McLeod Physician Associates II CurrentSince Jan 9, 2024 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince Sep 15, 2024 Accepting new patients

Locations

1234 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-1234

908 S Williamson Ave
Elon, NC 27244
Phone (336) 538-1234

101 Medical Park Dr
Mebane, NC 27302
Phone (336) 538-1234

555 E Cheves St
Florence, SC 29506
Phone (843) 662-5233

800 E Cheves St
Ste 240
Florence, SC 29506
Phone (843) 777-7950

800 E Cheves St
Ste 480A
Florence, SC 29506
Phone (843) 777-7337

506 E Cheves St
#202
Florence, SC 29506

3793 McDowell Ln
Ste 200
Little River, SC 29566
Phone (843) 390-0877

3485 Mitchell St
Loris, SC 29569
Phone (843) 390-0877

107 McLeod Health Blvd
Bldg 3
Myrtle Beach, SC 29579
Phone (843) 366-3920

Interoperability endpoints

  • Direct secure messaging: bkowalski88774@directmcleodehealth.org

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359504000000",
    "number": "1467479808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1717",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272161717",
            "telephone_number": "336-538-1234",
            "fax_number": "336-538-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 HUFFMAN MILL RD",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272158700",
            "telephone_number": "336-538-1234",
            "fax_number": "336-538-2390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALSKI",
        "first_name": "BRUCE",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2013-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "97-00624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8910494",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, NC

Sources for this page

Verify at the official NPI Registry.