NPIMap

Individual provider Active NPI

Kurtis Jon Melin, MD

  • Family Medicine Physician
  • Spartanburg, SC
National Provider Identifier
1467749929
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
38595 Issued in SC
Practice address
1530 Drayton Road
Spartanburg, SC 29307-1058
Phone
(864) 560-6012
Fax
(864) 560-6013
NPI assigned
Jul 6, 2011
Last updated
Feb 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301099284 MI
Family Medicine Physician 207Q00000X 38595 SC Primary

Addresses

Primary practice location

1530 Drayton Road
Spartanburg, SC 29307-1058

Mailing address

PO Box 743070
Atlanta, GA 30374-3070
Phone (864) 560-4304

Other identifiers 2

IdentifierTypeStateIssuer
385591MedicaidSC
SC61755019OtherSCMEDICARE PIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmelin77966@direct-srhs.et0939.epichosted.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150813011909 SC Practitioner - Family PracticePractitioner - Geriatric Medicine 6901024629 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spartanburg Medical CenterGroup PAC ID 3072425297, 1,060 clinicians

Practice addresses (Care Compare)

100 E Wood St
Suite 300a
Spartanburg, SC 29303-3059
Phone (864) 560-6012

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301099284MIMDFamily Medicine Physician
38595SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center Family Medicine CurrentSince Jun 26, 2015 Accepting new patients
Spartanburg Medical Center Current Accepting new patients
Spartanburg Medical Center Family Medicine PastSince Feb 26, 2023 Accepting new patients

Locations

100 E Wood St
Ste 300A
Spartanburg, SC 29303
Phone (864) 560-6012

101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915

101 E Wood St
Ste 300
Spartanburg, SC 29303
Phone (864) 560-6554

Interoperability endpoints

  • Direct secure messaging: kmelin77966@direct-srhs.et0939.epichosted.com

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
White Oak EstatesSpartanburg, SC, CCN 425290 Skilled nursing facility Contracted Managing Employee (5%) Feb 28, 2024
Ellen Sagar Nursing CenterUnion, SC, CCN 425012 Skilled nursing facility Adp of the SNF Jan 30, 2025
Woodruff ManorWoodruff, SC, CCN 425179 Skilled nursing facility Adp of the SNF Jan 31, 2025

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1467749929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743070",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743070",
            "telephone_number": "864-560-4304",
            "fax_number": "864-560-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 DRAYTON ROAD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071058",
            "telephone_number": "864-560-6012",
            "fax_number": "864-560-6013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELIN",
        "first_name": "KURTIS",
        "middle_name": "JON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-06",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301099284",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "38595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "385591",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SC61755019",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmelin77966@direct-srhs.et0939.epichosted.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kmelin77966@direct-srhs.et0939.epichosted.com",
            "address_1": "1530 Drayton Road",
            "city": "Spartanburg",
            "state": "SC",
            "country_code": "US",
            "postal_code": "293071058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.