Kevin Neely Blackmon, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

31776 Issued in SC

Practice address

1210 W Faris Rd
Greenville, SC 29605

Phone

(864) 522-1800

Fax

(864) 522-1806

NPI assigned

Jun 11, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Interventional RadiologyAlso: Diagnostic Radiology

Education

Medical University of South Carolina College of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prisma Health University Medical GroupGroup PAC ID 8325950983, shared by 5 NPIs, 2,467 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078
• Prisma Health Baptist Easley Hospital Hospital, Easley, SC, CCN 420015
• Prisma Health Patewood Hospital Hospital, Greenville, SC, CCN 420102
• Prisma Health Oconee Memorial Hospital Hospital, Seneca, SC, CCN 420009
• Prisma Health Greer Memorial Hospital Hospital, Spartanburg, SC, CCN 420033

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kblackmon250096@direct.ghs.myhfn.org

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.

• Prisma Health University Medical Group

  • Diagnostic Radiology Physician
  • Greenville, SC
  • NPI 1568799955
  Medicare reassignment NPD
• Prisma Health University Medical Group

  • Diagnostic Radiology Physician
  • Columbia, SC
  • NPI 1730786096
  Medicare reassignment NPD
• Prisma Health University Medical Group

  • Gynecology Physician
  • Greer, SC
  • NPI 1003619313
  NPD

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

• Prisma Health-Upstate

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1033664909
  Care Compare affiliation
• Prisma Health-Upstate

  • General Acute Care Hospital
  • Seneca, SC
  • NPI 1063968196
  Care Compare affiliation
• Prisma Health-Upstate

  • Medically Fragile Infants and Children Day Care
  • Greenville, SC
  • NPI 1093168064

  Hospital

  Care Compare affiliation
• Prisma Health-Upstate

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1114473212
  Care Compare affiliation
• Prisma Health-Upstate

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1124574223
  Care Compare affiliation
• Prisma Health-Upstate

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1144775032
  Care Compare affiliation
• Prisma Health-Upstate

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1144914607
  Care Compare affiliation
• Prisma Health-Upstate

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1174079271
  Care Compare affiliation
• Prisma Health-Upstate

  • Radiology Clinic/Center
  • Greenville, SC
  • NPI 1235685330

  Hospital

  Care Compare affiliation
• Prisma Health-Upstate

  • Sleep Disorder Diagnostic Clinic/Center
  • Greenville, SC
  • NPI 1275086431

  Hospital

  Care Compare affiliation
• Prisma Health-Upstate

  • Multi-Specialty Clinic/Center
  • Greenville, SC
  • NPI 1285180307

  Hospital

  Care Compare affiliation
• Prisma Health-Upstate

  • Clinic/Center
  • Greenville, SC
  • NPI 1316492218

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1244678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1679700140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 W FARIS RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "29605",
            "telephone_number": "864-522-1800",
            "fax_number": "864-522-1806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "169 Ashley Ave",
            "address_2": "MSC333",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294258905",
            "country_code": "US",
            "telephone_number": "843-792-2575",
            "fax_number": "843-792-9295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "169 Ashley Ave",
            "address_2": "MSC333",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294258905",
            "country_code": "US",
            "telephone_number": "843-792-2575",
            "fax_number": "843-792-9295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1519 Marion St",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292012910",
            "country_code": "US",
            "telephone_number": "803-296-5954",
            "fax_number": "803-296-3076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKMON",
        "first_name": "KEVIN",
        "middle_name": "NEELY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-11",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "31776",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "SC",
            "license": "2031776",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "317767",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kblackmon250096@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kblackmon250096@direct.ghs.myhfn.org",
            "address_1": "1210 W Faris Rd",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "29605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joshua Daniel Black, DC
• Keith Black, DPT
• Tammy Lynn Black, NP
• Teonna Black
• Corinne Blackmon, MA, LCMHC, LPC
• Charlaina Blackstock
• Barry C Blackston, M.D.
• Alice Blackwell, M.ED, E.DS., LPC-A
• Andrea K Blackwell, LCSW
• Ann Kathryn Blackwell, RN

• Diagnostic Radiology Physician in Greenville, SC
• Providers in Greenville, SC by specialty
• Diagnostic Radiology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.