Individual provider Active NPI

Anna Maria A Kammeyer, PA-C

  • Physician Assistant
  • Charleston, SC
National Provider Identifier
1467686816
Registry record updated Oct 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
005570 Issued in GA
Practice address
2295 Henry Tecklenburg Dr
Charleston, SC 29414-7801
Phone
(843) 766-7103
Fax
(843) 576-2592
NPI assigned
May 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 005570 GA Primary

Addresses

Primary practice location

2295 Henry Tecklenburg Dr
Charleston, SC 29414-7801

Mailing address

2295 Henry Tecklenburg Dr
Charleston, SC 29414-7801
Phone (843) 766-7103

Other identifiers 2

IdentifierTypeStateIssuer
5570OtherGAMEDICAL LICENSE
1685OtherSCMEDICAL LICENSE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111117000683 SC Practitioner - Physician Assistant 6204988272 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
005570GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ears to You LLC Current Accepting new patients
Charleston ENT Associates, LLC CurrentSince Sep 28, 2011 Accepting new patients
Peachtree Orthopaedic Clinic PA Past Accepting new patients

Locations

2295 Henry Tecklenburg Dr
Charleston, SC 29414

1849 Savage Rd
Charleston, SC 29407
Phone (843) 576-2600

Interoperability endpoints

  • Direct secure messaging: anna.kammeyer.p1@direct.entap.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1242172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445299200000",
    "number": "1467686816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2295 HENRY TECKLENBURG DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294147801",
            "telephone_number": "843-766-7103",
            "fax_number": "843-576-2592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2295 HENRY TECKLENBURG DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294147801",
            "telephone_number": "843-766-7103",
            "fax_number": "843-576-2592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMMEYER",
        "first_name": "ANNA MARIA",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-13",
        "last_updated": "2015-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "005570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "5570",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "1685",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.