Kennedy Toole, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

1194448 Issued in SC

Practice address

3045 Saint Matthews Rd
Orangeburg, SC 29118-1443

Phone

(803) 747-7242

NPI assigned

Oct 17, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1619693132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 COMET CREEK LN",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294868045",
            "telephone_number": "803-474-2043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3045 SAINT MATTHEWS RD",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291181443",
            "telephone_number": "803-747-7242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOOLE",
        "first_name": "KENNEDY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-17",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SC",
            "license": "1194448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Orangeburg, SC
• Providers in Orangeburg, SC by specialty
• Surgical Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.