NPIMap

Individual provider Active NPI

Kameron Burke Klosterman, MD

  • Family Medicine Physician
  • Pacolet, SC
National Provider Identifier
1609984715
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
27023 Issued in SC
Practice address
7221 S Pine St
Pacolet, SC 29372-3122
Phone
(864) 474-1528
Fax
(864) 474-1049
NPI assigned
Aug 28, 2006
Last updated
Mar 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 27023 SC Primary

Addresses

Primary practice location

7221 S Pine St
Pacolet, SC 29372-3122

Mailing address

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

Other identifiers 4

IdentifierTypeStateIssuer
9997050OtherSCAETNA
SC9525J577OtherSCMEDICARE PIN
270236MedicaidSC
P01221611OtherSCRAIRLROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050411001290 SC Practitioner - Family Practice 8426095480 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Georgia School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spartanburg Medical CenterGroup PAC ID 3072425297, shared by 17 NPIs, 1,060 clinicians

Practice addresses (Care Compare)

151 Peachwood Centre Dr
Spartanburg, SC 29301-2575
Phone (864) 560-9627

7221 S Pine St
Pacolet, SC 29372-3122
Phone (864) 474-1528

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center Current Accepting new patients
Spartanburg Medical Center Family Medicine Current Accepting new patients
Cherokee Medical Center CurrentSince Feb 1, 2021 Accepting new patients
Cherokee Medical Center Family Medicine Current Accepting new patients
Spartanburg Medical Center Family Medicine CurrentSince Jul 1, 2004 Accepting new patients
Spartanburg Medical Center Family Medicine CurrentSince Aug 20, 2007 Accepting new patients
Cherokee Medical Center CurrentSince Feb 1, 2021 Accepting new patients
Spartanburg Medical Center Past Accepting new patients
Mary Black Health System LLC Past Accepting new patients

Locations

840 W Floyd Baker Blvd
Gaffney, SC 29341
Phone (864) 489-3300

7221 S Pine St
Pacolet, SC 29372
Phone (864) 474-1528

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

1200 E Main St
Ste 12
Spartanburg, SC 29307
Phone (864) 560-9260

151 Peachwood Centre Dr
Spartanburg, SC 29301
Phone (864) 560-9627

2995 Reidville Rd
Ste 100
Spartanburg, SC 29301
Phone 8645873000 ext. 86458

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1609984715",
    "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": "7221 S PINE ST",
            "city": "PACOLET",
            "state": "SC",
            "postal_code": "293723122",
            "telephone_number": "864-474-1528",
            "fax_number": "864-474-1049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOSTERMAN",
        "first_name": "KAMERON",
        "middle_name": "BURKE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "27023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9997050",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SC9525J577",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270236",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIRLROAD MEDICARE",
            "identifier": "P01221611",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacolet, SC

Sources for this page

Verify at the official NPI Registry.