Individual provider Active NPI

Kent B Sizemore, MD

  • Pediatrics Physician
  • Anderson, SC
National Provider Identifier
1639199664
Registry record updated Apr 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
18291 Issued in SC
Practice address
500 N Fant St
Suite C
Anderson, SC 29621-5702
Phone
(864) 225-7798
Fax
(864) 260-3952
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 18291 SC Primary

Addresses

Primary practice location

500 N Fant St
Suite C
Anderson, SC 29621-5702

Mailing address

109 Essex Dr
Anderson, SC 29621-3318
Phone (864) 512-3850

Other identifiers 1

IdentifierTypeStateIssuer
182910MedicaidSC

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
I20140310001733 SC Practitioner - Pediatric Medicine 7517878325 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18291SCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beaufort County Memorial Hospital CurrentSince Jun 24, 2019 Accepting new patients
McLeod Health Clarendon CurrentSince Sep 28, 2021 Accepting new patients
Beaufort County Memorial Hospital CurrentSince Jun 24, 2019 Accepting new patients
McLeod Health Clarendon CurrentSince Sep 28, 2021 Accepting new patients
Anmed Health Past Accepting new patients
Anmed Health Pediatrics Past Accepting new patients

Locations

955 Ribaut Rd
Beaufort, SC 29902
Phone (803) 522-5200

989 Ribaut Rd
Ste 260
Beaufort, SC 29902
Phone (843) 522-7600

10 E Hospital St
Manning, SC 29102
Phone (803) 433-3000

1680 Ribaut Rd
Port Royal, SC 29935
Phone (843) 522-7600

Interoperability endpoints

  • Direct secure messaging: kent.sizemore.1@16436.direct.athenahealth.com

Organizations & group practices 6

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272326400000",
    "number": "1639199664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 ESSEX DR",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296213318",
            "telephone_number": "864-512-3850",
            "fax_number": "864-512-3852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N FANT ST",
            "address_2": "SUITE C",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296215702",
            "telephone_number": "864-225-7798",
            "fax_number": "864-260-3952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIZEMORE",
        "first_name": "KENT",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2010-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "18291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182910",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

Verify at the official NPI Registry.