Individual provider Active NPI

Karcy Grove Clark, PA

  • Physician Assistant
  • Spartanburg, SC
National Provider Identifier
1497397004
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3387 Issued in SC
Practice address
480 Floyd Rd Ste a
Spartanburg, SC 29307-1518
Phone
(864) 582-2188
Fax
(864) 582-2117
NPI assigned
Oct 15, 2019
Last updated
Oct 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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 3387 SC Primary

Addresses

Primary practice location

480 Floyd Rd Ste a
Spartanburg, SC 29307-1518

Mailing address

PO Box 743070
Atlanta, GA 30374-3070

Other practice location 1

317 Saint Francis Dr Ste 310
Greenville, SC 29601-3968
Phone (864) 234-9900

Other identifiers 2

IdentifierTypeStateIssuer
3946PAMedicaidSC
SCG4977628OtherSCMEDICARE PIN

Other names 1

  • Karcy Elizabeth Grove Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kgrove191044@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: 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
I20191217001774 SC Practitioner - Physician Assistant 1759715238 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Saint Francis Dr
Greenville, SC 29601-3955
Phone (513) 853-8520

125 Commonwealth Dr
Greenville, SC 29615-4812
Phone (864) 675-4000

180 Halton Rd
Greenville, SC 29607-3508
Phone (864) 220-4263

3 Saint Francis Dr
Greenville, SC 29601-3972

317 Saint Francis Dr
Suite 220
Greenville, SC 29601-3976
Phone (864) 255-1901

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3387SCMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince Dec 8, 2024 Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince Dec 8, 2024 Accepting new patients
Spartanburg Medical Center CurrentSince Oct 7, 2019 Accepting new patients
Spartanburg Medical Center CurrentSince Oct 7, 2019 Accepting new patients

Locations

317 Saint Francis Dr
Ste 220
Greenville, SC 29601
Phone (864) 255-1901

317 Saint Francis Dr
Ste 310
Greenville, SC 29601
Phone (864) 233-2744

100 E Wood St
Spartanburg, SC 29303
Phone (864) 560-7070

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

480 Floyd Rd
Ste A
Spartanburg, SC 29307
Phone (864) 582-2188

853 N Church St
Ste 410A
Spartanburg, SC 29303
Phone (864) 560-6928

Interoperability endpoints

  • Direct secure messaging: kclark2723366@direct.bsmhealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1571097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1497397004",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 FLOYD RD STE A",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071518",
            "telephone_number": "864-582-2188",
            "fax_number": "864-582-2117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "317 Saint Francis Dr Ste 310",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296013968",
            "country_code": "US",
            "telephone_number": "864-234-9900",
            "fax_number": "864-234-9090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KARCY",
        "middle_name": "GROVE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-15",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "3387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3946PA",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCG4977628",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgrove191044@direct-srhs.et0939.epichosted.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kgrove191044@direct-srhs.et0939.epichosted.com",
            "address_1": "480 Floyd Rd Ste A",
            "city": "Spartanburg",
            "state": "SC",
            "country_code": "US",
            "postal_code": "293071518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KARCY",
            "last_name": "GROVE",
            "middle_name": "ELIZABETH",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.