Individual provider Active NPI

Kylie Colvin

  • Surgery Physician
  • Columbia, SC
National Provider Identifier
1659076032
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
LL89941 Issued in SC
Practice address
2 Medical Park Rd
Columbia, SC 29203-6808
Phone
(803) 434-8198
NPI assigned
Apr 4, 2023
Last updated
Jul 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X LL89941 SC Primary

Addresses

Primary practice location

2 Medical Park Rd
Columbia, SC 29203-6808

Mailing address

2 Medical Park Rd
Columbia, SC 29203-6808

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
I20230907004009 SC Order and Referring Only - General SurgeryPractitioner - General Surgery 6305200437

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol PastSince Apr 9, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1680566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1659076032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MEDICAL PARK RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MEDICAL PARK RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036808",
            "telephone_number": "803-434-8198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLVIN",
        "first_name": "KYLIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-04",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "LL89941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.