Active NPI
Karen L. Staples, FNP
- Adult Health Nurse Practitioner
- Loris, SC
National Provider Identifier
1588760904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 1211
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20630 | Other | SC | NP 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201657 | NC | MD | Certified Registered Nurse Anesthetist |
Interoperability endpoints
- 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.