Individual provider Active NPI

Kelly Slotin, PA

  • Dermatology Physician
  • Charleston, SC
National Provider Identifier
1689435463
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
5165 Issued in SC
Practice address
135 Rutledge Ave # Msc578
Charleston, SC 29425-8903
Phone
(843) 792-9155
NPI assigned
Jan 19, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 5165 SC Primary

Addresses

Primary practice location

135 Rutledge Ave # Msc578
Charleston, SC 29425-8903

Mailing address

PO Box 751461
Charlotte, NC 28275-1461
Phone (843) 792-6200

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240326001499 SC Practitioner - Physician Assistant 1557708591 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercer University School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Medical Associates of the Medical University of South CarolGroup PAC ID 6305758574, 1,634 clinicians

Practice addresses (Care Compare)

167 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

2060 Sam Rittenberg Blvd
Charleston, SC 29407-4616
Phone (843) 792-1414

Hospital & facility affiliations

  • Musc Medical Center Hospital, Charleston, SC, CCN 420004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5165SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol CurrentSince Jan 18, 2024 Accepting new patients

Locations

135 Rutledge Ave
#578
Charleston, SC 29425
Phone (843) 792-5858

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

5500 Front St
Summerville, SC 29486
Phone (843) 712-1414

Interoperability endpoints

  • Direct secure messaging: kslotin455639@direct.musc.edu

Organizations & group practices 2

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": "1705622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1689435463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 RUTLEDGE AVE # MSC578",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258903",
            "telephone_number": "843-792-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOTIN",
        "first_name": "KELLY",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-19",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "SC",
            "license": "5165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.