Active NPI
Anna C Kelly, MD
- Pain Medicine (Anesthesiology) Physician
- Florence, SC
National Provider Identifier
1679799209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Anesthesiology) Physician
- License
- 22597
- Practice address
- 600 E Palmetto St
Florence, SC 29506-2851 - Phone
- (843) 667-9414
- Fax
- (843) 407-9726
- NPI assigned
- Apr 18, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 034624 | GA | |
| Addiction Medicine (Anesthesiology) Physician | 207LA0401X | 69003 | WI | |
| Addiction Medicine (Preventive Medicine) Physician | 2083A0300X | 69003 | WI | |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 22597 | SC | Primary |
Addresses
Primary practice location
600 E Palmetto St
Florence, SC 29506-2851
Mailing address
360 N Irby St
Florence, SC 29501-2808
Phone (843) 667-9414
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI, SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Preventive Medicine
- Education
- Emory University School of Medicine, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
360 N Irby St
Florence, SC 29501-2808
Phone (843) 667-9414
600 E Palmetto St
Florence, SC 29506-2851
Phone (843) 667-9414
Hospital & facility affiliations
- Gundersen Lutheran Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 034624 | GA | MD | Acupuncturist |
| 69003 | WI | MD | Addiction Medicine (Preventive Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gundersen Lutheran Medical Center, Inc | Current | Accepting new patients | |
| Hopehealth Inc | Current | Accepting new patients | |
| Hopehealth Inc | Current | Accepting new patients | |
| Gundersen Lutheran Medical Center Inc | Current | Accepting new patients |
Locations
360 N Irby St
Florence, SC 29501
Phone (843) 656-0353
600 E Palmetto St
Florence, SC 29506
Phone (843) 656-0390
1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102
1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287
Interoperability endpoints
- akelly288129@direct.emplifyhealth.org
Organizations & group practices 4
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.
-
- Federally Qualified Health Center (FQHC)
- Florence, SC
- NPI 1821002411
-
- Clinic/Center
- La Crosse, WI
- NPI 1225873458
-
- Federally Qualified Health Center (FQHC)
- Lake City, SC
- NPI 1649069618
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Onalaska, WI
- NPI 1871837567
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- La Crosse, WI
- NPI 1376593442
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Onalaska, WI
- NPI 1871837567
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700092800000",
"number": "1679799209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "360 N IRBY ST",
"city": "FLORENCE",
"state": "SC",
"postal_code": "295012808",
"telephone_number": "843-667-9414",
"fax_number": "843-407-9726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 E PALMETTO ST",
"city": "FLORENCE",
"state": "SC",
"postal_code": "295062851",
"telephone_number": "843-667-9414",
"fax_number": "843-407-9726"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "ANNA",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-18",
"last_updated": "2023-11-16",
"certification_date": "2023-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "GA",
"license": "034624",
"primary": false
},
{
"code": "207LA0401X",
"taxonomy_group": "",
"desc": "Anesthesiology, Addiction Medicine",
"state": "WI",
"license": "69003",
"primary": false
},
{
"code": "2083A0300X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Addiction Medicine",
"state": "WI",
"license": "69003",
"primary": false
},
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "SC",
"license": "22597",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Florence, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; 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.