NPIMap

Individual provider Active NPI

Ryan Michael Keklik, DO

  • Emergency Medicine Physician
  • Charleston, SC
National Provider Identifier
1689314684
Registry record updated May 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
94478 Issued in SC
Practice address
169 Ashley Avenue
Room 202 Main Hospital Msc333
Charleston, SC 29425
Phone
(203) 209-4341
NPI assigned
Mar 30, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 94478 SC
Emergency Medicine Physician 207P00000X 94478 SC Primary

Addresses

Primary practice location

169 Ashley Avenue
Room 202 Main Hospital Msc333
Charleston, SC 29425

Mailing address

169 Ashley Avenue
Room 202 Main Hospital Msc333
Charleston, SC 29425

Other practice location 1

3500 Gaston Ave
Dallas, TX 75246-2017
Phone (203) 209-4341

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
I20260108003752 SC Practitioner - Emergency Medicine 5698155836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians

Practice addresses (Care Compare)

3000 Saint Matthews Rd
Orangeburg, SC 29118-1442
Phone (803) 395-3400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
94478SCMDCritical Care Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Musc Community Physicians CurrentSince Jan 1, 2026 Accepting new patients
Musc Community Physicians CurrentSince Jan 1, 2026 Accepting new patients

Locations

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

3000 Saint Matthews Rd
Orangeburg, SC 29118
Phone (803) 395-2200

Interoperability endpoints

  • Direct secure messaging: rkeklik1063332@direct.sw.org

Organizations & group practices 3

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 6

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

NPI Registry JSON

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748649600000",
    "number": "1689314684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVENUE",
            "address_2": "ROOM 202 MAIN HOSPITAL MSC333",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVENUE",
            "address_2": "ROOM 202 MAIN HOSPITAL MSC333",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29425",
            "telephone_number": "203-209-4341"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3500 Gaston Ave",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752462017",
            "country_code": "US",
            "telephone_number": "203-209-4341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEKLIK",
        "first_name": "RYAN",
        "middle_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-30",
        "last_updated": "2025-05-31",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "SC",
            "license": "94478",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "94478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.