Individual provider Active NPI

Kelton Banks Wigington, MD

  • Ophthalmology Physician
  • Rock Hill, SC
National Provider Identifier
1679914212
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
36094 Issued in SC
Practice address
1773 Ebenezer Rd
Rock Hill, SC 29732-1101
Phone
(803) 981-5614
Fax
(803) 325-8473
NPI assigned
Jul 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X LL36094 SC
Ophthalmology Physician 207W00000X 36094 SC Primary

Addresses

Primary practice location

1773 Ebenezer Rd
Rock Hill, SC 29732-1101

Mailing address

1773 Ebenezer Rd
Rock Hill, SC 29732-1101
Phone (803) 328-0168

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
I20170925001733 SC Practitioner - Ophthalmology 4981978202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of South Carolina School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rock Hill Eye Clinic PAGroup PAC ID 8921083502, 6 clinicians

Practice addresses (Care Compare)

1773 Ebenezer Rd
Rock Hill, SC 29732-1101
Phone (803) 328-0168

Merit-based Incentive Payment System (MIPS)

Final score
91.48 of 100Reported as group
Quality
91.19
Improvement activities
40
Cost
83.33

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery336

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36094SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rock Hill Eye Clinic, P.a. Ophthalmology CurrentSince Jul 31, 2017 Accepting new patients

Locations

1698 Highway 160 W
Ste 110
Fort Mill, SC 29708
Phone (803) 547-9510

1773 Ebenezer Rd
Rock Hill, SC 29732
Phone (803) 328-0168

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1373500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1679914212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1773 EBENEZER RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321101",
            "telephone_number": "803-328-0168",
            "fax_number": "803-325-8473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1773 EBENEZER RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321101",
            "telephone_number": "803-981-5614",
            "fax_number": "803-325-8473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGINGTON",
        "first_name": "KELTON",
        "middle_name": "BANKS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-11",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "LL36094",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "36094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.