Brad Richard Kelly, D.O.
Individual provider Active NPI Family Medicine Physician · Varnville, SC
NPI 1609284223 · NPPES record last updated May 11, 2020
Key facts
- NPI
- 1609284223
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 39359 (SC)
- Practice address
- 1000 Pine St W
Varnville, SC 29944-4750 - Phone
- (803) 943-7702
- NPI assigned
- Jul 28, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Beaufort County Memorial Hospital
Practice addresses (Care Compare)
1 Burnt Church Rd
Suite B
Bluffton, SC 29910-6405
Phone (843) 706-2287
300 Midtown Dr
Beaufort, SC 29906-5200
Phone (843) 770-0404
Hospital & facility affiliations
- Beaufort County Memorial Hospital
- Hampton Regional Medical Center
- Novant Health Hilton Head Medical Center
- Candler Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.95 of 100
- Quality
- 83.15
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 73.35
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171006002263 | SC | Practitioner - Family Practice | 3375820368 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R3239 | KY | MD | Family Medicine Physician |
| 58.005341 | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beaufort County Memorial Hospital | Current |
Accepting new patients | |
| Beaufort County Memorial Hospital | Current |
Accepting new patients | |
| Beaufort County Memorial Hospital | Current | Accepting new patients | |
| Beaufort County Memorial Hospital | Family Medicine | Current |
Accepting new patients |
| Beaufort County Memorial Hospital | Past | Accepting new patients | |
| Windber Hospital, Inc. | Past | Accepting new patients |
Locations
989 Ribaut Rd
Ste 103
Beaufort, SC 29902
Phone (843) 522-5351
955 Ribaut Rd
Beaufort, SC 29902
Phone (803) 522-5200
955 Ribaut Rd
#C
Beaufort, SC 29902
300 Midtown Dr
Beaufort, SC 29906
Phone (843) 379-7746
1 Burnt Church Rd
#B
Bluffton, SC 29910
Phone (843) 706-2287
1680 Ribaut Rd
Port Royal, SC 29935
Phone (843) 522-7600
1000 Pine St W
Varnville, SC 29944
Phone (803) 943-5228
Interoperability endpoints
- brad.kelly.1@16436.direct.athenahealth.com
- bradkelly@hphcc.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | R3239 | KY | |
| Family Medicine Physician | 207Q00000X | 58.005341 | OH | |
| Family Medicine Physician | 207Q00000X | 39359 | SC | Yes |
Addresses
Primary practice location
1000 Pine St W
Varnville, SC 29944-4750
Mailing address
1000 Pine St W
Varnville, SC 29944-4750
Phone (803) 943-7702
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 393596 | Medicaid | SC |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | www.bmhsc.org |
Other providers in Varnville, SC
- Hampton School District One
- Harold B Harvey
- Malcolm H Horry
- Mallory Ryan Hunt
- Inner Peace Counseling Services, LLC
- Jill Thomas Knight
- Let Ryde LLC
- Paul Michael Linnert
- Low Country Family Services, Inc.
- Low Country Health Care Network
All providers in Varnville, SC · Family Medicine Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 11, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.