Individual provider Active NPI

Karen L. Staples, FNP

  • Adult Health Nurse Practitioner
  • Loris, SC
National Provider Identifier
1588760904
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
1211 Issued in SC
Practice address
3418 Casey St
Loris, SC 29569-2904
Phone
(843) 756-7885
Fax
(843) 756-7855
NPI assigned
Sep 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201657 NC
Adult Health Nurse Practitioner 363LA2200X 1211 SC Primary

Addresses

Primary practice location

3418 Casey St
Loris, SC 29569-2904

Mailing address

PO Box 3239
Florence, SC 29502-3239
Phone (843) 756-7885

Other practice location 1

690 Sunset Blvd N Ste 109
Sunset Beach, NC 28468-5610
Phone (910) 575-8488

Other identifiers 1

IdentifierTypeStateIssuer
20630OtherSCNP LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20180702001052 NC Practitioner - Nurse Practitioner 1456425107 Reassigns benefits to 1 organization
Practice locations: Sunset Beach, NC

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201657NCMDCertified Registered Nurse Anesthetist

Interoperability endpoints

  • Direct secure messaging: kstaples32519@directmcleodehealth.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1588760904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3239",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295023239",
            "telephone_number": "843-756-7885",
            "fax_number": "843-756-7855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3418 CASEY ST",
            "city": "LORIS",
            "state": "SC",
            "postal_code": "295692904",
            "telephone_number": "843-756-7885",
            "fax_number": "843-756-7855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "690 Sunset Blvd N Ste 109",
            "address_purpose": "LOCATION",
            "city": "Sunset Beach",
            "state": "NC",
            "postal_code": "284685610",
            "country_code": "US",
            "telephone_number": "910-575-8488",
            "fax_number": "910-575-6542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAPLES",
        "first_name": "KAREN",
        "middle_name": "L.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "201657",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "SC",
            "license": "1211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE NUMBER",
            "identifier": "20630",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loris, SC

Sources for this page

Verify at the official NPI Registry.