Individual provider Active NPI

Kathryn Massengill, PA-C

  • Physician Assistant
  • Spartanburg, SC
National Provider Identifier
1578890638
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1444 Issued in SC
Practice address
853 N Church St Ste 600
Spartanburg, SC 29303-3070
Phone
(645) 834-5568
Fax
(864) 756-0062
NPI assigned
Nov 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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 1444 SC Primary

Addresses

Primary practice location

853 N Church St Ste 600
Spartanburg, SC 29303-3070

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
SCG2896162OtherSCMEDICARE PIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmassengill111098@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
I20191114002765 SC Practitioner - Physician Assistant 1052743978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical University of South Carolina College of Medicine, 2009
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)

101 E Wood St
Spartanburg, SC 29303-3040

1686 Skylyn Dr
Suite 101
Spartanburg, SC 29307-1079
Phone (864) 585-3456

853 N Church St
Suite 600
Spartanburg, SC 29303-3070
Phone (864) 583-4556

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
1444SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center CurrentSince Jul 13, 2020 Accepting new patients
Spartanburg Medical Center CurrentSince Jul 13, 2020 Accepting new patients
Spartanburg Medical Center Past Accepting new patients

Locations

3981 Highway 9
Ste 201
Boiling Springs, SC 29316
Phone (864) 278-1400

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

250 North Grove Medical Park Dr
#D
Spartanburg, SC 29303
Phone (864) 208-2345

250 North Grove Medical Park Dr
Spartanburg, SC 29303
Phone (864) 208-2345

853 N Church St
Ste 600
Spartanburg, SC 29303
Phone (864) 583-4556

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

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1257897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1578890638",
    "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": "853 N CHURCH ST STE 600",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033070",
            "telephone_number": "645-834-5568",
            "fax_number": "864-756-0062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSENGILL",
        "first_name": "KATHRYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-11",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "1444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCG2896162",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmassengill111098@direct-srhs.et0939.epichosted.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kmassengill111098@direct-srhs.et0939.epichosted.com",
            "address_1": "853 N Church St Ste 600",
            "city": "Spartanburg",
            "state": "SC",
            "country_code": "US",
            "postal_code": "293033070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.