NPIMap

Individual provider Active NPI

Kelley Brown Davis

  • Family Nurse Practitioner
  • Elgin, SC
National Provider Identifier
1669079901
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
24307 Issued in SC
Practice address
2689 US-1
Elgin, SC 29045
Phone
(803) 438-7698
NPI assigned
Oct 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 24307 SC Primary

Addresses

Primary practice location

2689 US-1
Elgin, SC 29045

Mailing address

758 Pate Rd
Camden, SC 29020-8382

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201209002160 SC Practitioner - Nurse Practitioner 3678985033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Musc Community Physicians 1,353 clinicians

Practice addresses (Care Compare)

2689 Hwy 1 S
Elgin, SC 29045-9055
Phone (803) 438-7698

Hospital & facility affiliations

  • Amedisys Home Health of Camden Home health agency, Camden, SC, CCN 427036
  • Kershawhealth Hospital, Camden, SC, CCN 420048
  • Musc Health Columbia Medical Center Downtown Hospital, Columbia, SC, CCN 420026
  • Musc Medical Center Hospital, Charleston, SC, CCN 420004

Merit-based Incentive Payment System (MIPS)

Final score
80.41 of 100Reported as group
Quality
64.93
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24307SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Musc Community Physicians CurrentSince Aug 1, 2021 Accepting new patients
Musc Community Physicians CurrentSince Aug 1, 2021 Accepting new patients
Musc Community Physicians Current Accepting new patients
Regional Medical Center of Orangeburg and Calhoun Counties Past Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

2034 W DeKalb St
Camden, SC 29020
Phone (803) 438-0825

1344 Haile St
Camden, SC 29020
Phone (803) 254-3376

2001 Laurel St
Ste 300
Columbia, SC 29204
Phone (803) 254-2786

2689 Highway 1 S
Elgin, SC 29045
Phone (803) 438-7698

216 E Marion St
Kershaw, SC 29067
Phone (803) 475-3350

710 Dewitt Dr
Lugoff, SC 29078
Phone (803) 233-1730

Interoperability endpoints

  • Direct secure messaging: kdavis379639@direct.musc.edu

Organizations & group practices 11

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1669079901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "758 PATE RD",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290208382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2689 US-1",
            "city": "ELGIN",
            "state": "SC",
            "postal_code": "29045",
            "telephone_number": "803-438-7698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KELLEY",
        "middle_name": "BROWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-08",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "24307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, SC

Sources for this page

Verify at the official NPI Registry.