Active NPI
Kim C Terry, PA
- Physician Assistant
- Ehrhardt, SC
National Provider Identifier
1629124854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1153
- Practice address
- PO Box 309
Ehrhardt, SC 29081-0309 - Phone
- (803) 824-8367
- Fax
- (803) 676-0061
- NPI assigned
- Jan 29, 2007
- Last updated
- Oct 22, 2026
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1153 | SC | Primary |
Addresses
Primary practice location
PO Box 309
Ehrhardt, SC 29081-0309
Mailing address
86 Wren St
Barnwell, SC 29812-1529
Phone (803) 259-5762
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1096PA | Medicaid | SC | |
| 1153 | Other | SC | MEDICAL LICENSE |
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: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1153 | SC | MD | Registered Dietitian |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Low Country Health Care System
- Federally Qualified Health Center (FQHC)
- Farifax, SC
- NPI 1053475566
-
dba Padgett Family Practice
- Federally Qualified Health Center (FQHC)
- Bamberg, SC
- NPI 1821518556
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1792627200000",
"number": "1629124854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "86 WREN ST",
"city": "BARNWELL",
"state": "SC",
"postal_code": "298121529",
"telephone_number": "803-259-5762",
"fax_number": "803-259-3250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PO BOX 309",
"city": "EHRHARDT",
"state": "SC",
"postal_code": "290810309",
"telephone_number": "803-824-8367",
"fax_number": "803-676-0061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TERRY",
"first_name": "KIM",
"middle_name": "C",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-29",
"last_updated": "2026-10-22",
"certification_date": "2026-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "SC",
"license": "1153",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1096PA",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "1153",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ehrhardt, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2026; 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.