Active NPI
Kim O Masters, NP
- Nurse Practitioner
- Columbia, SC
National Provider Identifier
1538291448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- APRN 856
- Practice address
- 190 Parkridge Drive
Suite 250
Columbia, SC 29212-1747 - Phone
- (803) 407-3857
- NPI assigned
- Mar 9, 2007
- Last updated
- Sep 9, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APRN 856 | SC | Primary |
Addresses
Primary practice location
190 Parkridge Drive
Suite 250
Columbia, SC 29212-1747
Mailing address
PO Box 402145
Atlanta, GA 30384-2145
Phone (803) 296-7305
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NP1354 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN 856 | SC | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Palmetto Health | Past | Accepting new patients | |
| Prisma Health-Midlands | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Prisma Health Tuomey Hosptial
- General Acute Care Hospital
- Sumter, SC
- NPI 1326043548
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315526400000",
"number": "1538291448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 402145",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303842145",
"telephone_number": "803-296-7305",
"fax_number": "803-296-7330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 PARKRIDGE DRIVE",
"address_2": "SUITE 250",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292121747",
"telephone_number": "803-407-3857"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASTERS",
"first_name": "KIM",
"middle_name": "O",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-09",
"last_updated": "2011-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "SC",
"license": "APRN 856",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NP1354",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.