Individual provider Active NPI

Jeffrey John Kline, MD

  • Specialist
  • Charleston, SC
National Provider Identifier
1649255456
Registry record updated Oct 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
14251 Issued in SC
Practice address
1164 Northbridge Dr
Suite C
Charleston, SC 29407-3700
Phone
(843) 763-8851
Fax
(843) 763-8556
NPI assigned
Dec 14, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 14251 SC Primary

Addresses

Primary practice location

1164 Northbridge Dr
Suite C
Charleston, SC 29407-3700

Mailing address

1164-C Northbridge Drive
Charleston, SC 29407
Phone (843) 763-8851

Other identifiers 1

IdentifierTypeStateIssuer
142517MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14251SCMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351641600000",
    "number": "1649255456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1164-C NORTHBRIDGE DRIVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29407",
            "telephone_number": "843-763-8851",
            "fax_number": "843-763-8556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1164 NORTHBRIDGE DR",
            "address_2": "SUITE C",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294073700",
            "telephone_number": "843-763-8851",
            "fax_number": "843-763-8556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINE",
        "first_name": "JEFFREY",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2012-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "SC",
            "license": "14251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142517",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2012; 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.