Individual provider Active NPI

Kevin J Mewborn, MD

  • Emergency Medicine Physician
  • Greenville, SC
National Provider Identifier
1669435327
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
23198 Issued in SC
Practice address
701 Grove Rd
Greenville, SC 29605-5611
Phone
(864) 455-7000
NPI assigned
Apr 11, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 23198 SC Primary

Addresses

Primary practice location

701 Grove Rd
Greenville, SC 29605-5611

Mailing address

701 Carriage Hill Rd
Simpsonville, SC 29681-5281
Phone (864) 675-6153

Other identifiers 1

IdentifierTypeStateIssuer
231984MedicaidSC

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
I20040928000225 SC Practitioner - Emergency Medicine 6103895164 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23198SCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Hospital Inc Emergency Medicine CurrentSince Jan 1, 2014 Accepting new patients
Ich ER Services, LLC Emergency Medicine CurrentSince Sep 1, 2020 Accepting new patients
Vituity-South Carolina LLC Emergency Medicine CurrentSince Jan 1, 2021 Accepting new patients
Cep America LLC Emergency Medicine Current Accepting new patients
St. Francis Hospital, Inc. Current Accepting new patients
Emergencymd CurrentSince Mar 10, 2015 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Jul 9, 2024 Accepting new patients
St Francis Hospital Inc CurrentSince Jan 1, 2014 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Jul 9, 2024 Accepting new patients
Starting Point of Florence, Inc CurrentSince Jan 22, 2024 Accepting new patients
Acute Care Specialists, Inc. Emergency Medicine Past Accepting new patients
Emergency Physician Services Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

75 Remittance Dr
Dept 1363
Chicago, IL 60675

800 N Fant St
Anderson, SC 29621
Phone (864) 512-1000

1 Saint Francis Dr
Greenville, SC 29601
Phone (864) 225-1000

125 Commonwealth Dr
Greenville, SC 29615
Phone (864) 225-1800

2498 N Pleasantburg Dr
Ste A
Greenville, SC 29609
Phone (864) 236-4350

3970 Grandview Dr
Simpsonville, SC 29680
Phone (864) 255-1000

Interoperability endpoints

  • Direct secure messaging: kmewborn46024@direct.anmedhealth.net

Organizations & group practices 12

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": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669435327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 CARRIAGE HILL RD",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296815281",
            "telephone_number": "864-675-6153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 GROVE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296055611",
            "telephone_number": "864-455-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEWBORN",
        "first_name": "KEVIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "23198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "231984",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.