Individual provider Active NPI

Kasey Ann Miles

  • Nurse Practitioner
  • Cayce, SC
National Provider Identifier
1639959778
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
28635 Issued in SC
Practice address
3085 Taylor Rd
Cayce, SC 29033-2745
Phone
(803) 258-8240
NPI assigned
Oct 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X 28635 SC
Family Nurse Practitioner 363LF0000X 28635 SC
Nurse Practitioner 363L00000X 28635 SC Primary
Physical Medicine & Rehabilitation Physician 208100000X 28635 SC

Addresses

Primary practice location

3085 Taylor Rd
Cayce, SC 29033-2745

Mailing address

3085 Taylor Rd
Cayce, SC 29033-2745
Phone (803) 258-8240

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240725001952 SC Practitioner - Nurse Practitioner 0840736963 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Impact Physician Group Texas Physiatry Services LLCGroup PAC ID 9234628256, 6 clinicians
Impact Physician Group South Carolina LLCGroup PAC ID 9638579352, 7 clinicians

Practice addresses (Care Compare)

20 Pinnacle Pkwy
Elgin, SC 29045-8389
Phone (803) 438-8890

2918 12TH St Ext
Cayce, SC 29033-3752
Phone (803) 258-8240

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Impact Physician Group, LLC CurrentSince Dec 28, 2025 Accepting new patients
Impact Physician Group, South Carolina LLC Family CurrentSince Apr 26, 2024 Accepting new patients
Impact Physician Group Texas Physiatry Services LLC Physical Medicine & Rehabilitation CurrentSince Aug 15, 2025 Accepting new patients
Impact Physician Group Pulmonary LLC CurrentSince Dec 1, 2025 Accepting new patients

Locations

3085 Taylor Rd
Cayce, SC 29033
Phone (803) 258-8240

20 Pinnacle Pkwy
Elgin, SC 29045
Phone (260) 407-8007

Organizations & group practices 4

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": "1696464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1639959778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3085 TAYLOR RD",
            "city": "CAYCE",
            "state": "SC",
            "postal_code": "290332745",
            "telephone_number": "803-258-8240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3085 TAYLOR RD",
            "city": "CAYCE",
            "state": "SC",
            "postal_code": "290332745",
            "telephone_number": "803-258-8240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES",
        "first_name": "KASEY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-05",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "SC",
            "license": "28635",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "28635",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "28635",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "SC",
            "license": "28635",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cayce, SC

Sources for this page

Verify at the official NPI Registry.