Individual provider Active NPI

Bethany Ann Kennedy, M.D.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Charleston, SC
National Provider Identifier
1598409740
Registry record updated Feb 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
95251 Issued in SC
Practice address
10 McClennan Banks Dr
Charleston, SC 29401-1164
Phone
(843) 792-2300
NPI assigned
Apr 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 95251 SC Primary
Hospitalist Physician 208M00000X 95251 SC

Addresses

Primary practice location

10 McClennan Banks Dr
Charleston, SC 29401-1164

Mailing address

5535 Pettiford PL
North Charleston, SC 29406-3321
Phone (256) 503-4343

Other practice location 1

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone (843) 402-1634

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260305001615 SC Practitioner - Pediatric MedicinePractitioner - Hospitalist 7315441664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Hospitalist
Education
University of Alabama School of Medicine, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

8536 Palmetto Commerce Pkwy
Suite 501
Ladson, SC 29456-6700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours St. Francis Xavier Hospital, Inc. Hospitalist CurrentSince Mar 1, 2026 Accepting new patients

Locations

2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037

Interoperability endpoints

  • Direct secure messaging: bkennedy529592@direct.musc.edu

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1650844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771977600000",
    "number": "1598409740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5535 PETTIFORD PL",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294063321",
            "telephone_number": "256-503-4343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MCCLENNAN BANKS DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294011164",
            "telephone_number": "843-792-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2095 Henry Tecklenburg Dr",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294145733",
            "country_code": "US",
            "telephone_number": "843-402-1634",
            "fax_number": "843-402-1550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "BETHANY",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-25",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "SC",
            "license": "95251",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "SC",
            "license": "95251",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.