Kimberly Dunbar Cooney, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0010-08372 Issued in NC

Practice address

7182 Woodrow St Ste 200
Irmo, SC 29063-2958

Phone

(803) 749-1111

Fax

(803) 749-0050

NPI assigned

Jul 16, 2012

Last updated

Jun 11, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

South Carolina Internal Medicine Associates and Rehabilitation LLCGroup PAC ID 1759362072, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: kcooney596648@direct.ghs.myhfn.org

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.

• South Carolina Internal Medicine Associates and Rehabilitation,L.L.C.

  • Internal Medicine Physician
  • Irmo, SC
  • NPI 1760483382
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654905600000",
    "number": "1558616581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7182 WOODROW ST STE 200",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632958",
            "telephone_number": "803-749-1111",
            "fax_number": "803-749-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7182 WOODROW ST STE 200",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632958",
            "telephone_number": "803-749-1111",
            "fax_number": "803-749-0050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Wellness Blvd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Irmo",
            "state": "SC",
            "postal_code": "290632873",
            "country_code": "US",
            "telephone_number": "803-749-1111",
            "fax_number": "803-749-0050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Wellness Blvd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Irmo",
            "state": "SC",
            "postal_code": "290632872",
            "country_code": "US",
            "telephone_number": "803-749-1111",
            "fax_number": "803-749-0050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "608 E Columbia Ave",
            "address_purpose": "LOCATION",
            "city": "Leesville",
            "state": "SC",
            "postal_code": "290707318",
            "country_code": "US",
            "telephone_number": "803-532-8155",
            "fax_number": "803-532-9685",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7021 Saint Andrews Rd # 2",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292121177",
            "country_code": "US",
            "telephone_number": "803-749-1111",
            "fax_number": "803-749-0050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COONEY",
        "first_name": "KIMBERLY",
        "middle_name": "DUNBAR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-16",
        "last_updated": "2022-06-11",
        "certification_date": "2022-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "TL1794",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-08372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA-C MEDICAL  LICENSE",
            "identifier": "1794",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Columbia Lactation Care LLC
• Columbia Rehabilitation Clinic, Inc.
• Comfort Home Health Care Inc.
• Comprehensive Counseling
• Tiffany Conyers, LCSW, LISW-CP, PMH-C
• Cameron Copeland, OD
• James Cordan, PHMARMACIST
• Corehealth Inc (Realief Neuropathy Center of Columbia)
• Jill Corrigan, LISW-CP
• Amanda Cosby

• Medical Physician Assistant in Irmo, SC
• Providers in Irmo, SC by specialty
• Medical Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.