Individual provider Active NPI

Kyle Alan Vanmiddlesworth, DO

  • Diagnostic Radiology Physician
  • Charleston, SC
National Provider Identifier
1689920878
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
1680 Issued in SC
Practice address
169 Ashley Ave
Charleston, SC 29425-8905
Phone
(843) 792-2300
NPI assigned
Jul 25, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 1680 SC
Diagnostic Radiology Physician 2085R0202X 1680 SC Primary

Addresses

Primary practice location

169 Ashley Ave
Charleston, SC 29425-8905

Mailing address

169 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181211001100 NC Practitioner - Interventional Radiology 6709185192 Reassigns benefits to 4 organizations
I20230609002959 SC Practitioner - Diagnostic Radiology 6709185192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Carolina Health Care PAGroup PAC ID 9739087693, 122 clinicians
Greensboro Radiology PAGroup PAC ID 8729074901, 236 clinicians
Coastal Radiology Associates PLLCGroup PAC ID 8224002696, 25 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

1000 Medical Park Ave
New Bern, NC 28562-5248
Phone (252) 634-3278

1020 Medical Park Ave
New Bern, NC 28562-5248
Phone (252) 514-6685

1030 Medical Park Ave
New Bern, NC 28562-5248
Phone (336) 274-6682

1040 Medical Park Ave
New Bern, NC 28562-5248
Phone (336) 274-6682

1165 Cedar Point Blvd
Suite I
Cedar Point, NC 28584-1030
Phone (336) 274-6682

1258 Pine Valley Dr
New Bern, NC 28562-2938
Phone (336) 274-6682

1331 N Elm St
Greensboro, NC 27401-6304
Phone (336) 274-6682

137 Medical LN
Pollocksville, NC 28573-8200
Phone (336) 274-6682

2000 Neuse Blvd
New Bern, NC 28560-3449
Phone (336) 274-6682

2363 Chinquapin Rd
New Bern, NC 28562-9018
Phone (336) 274-6682

2654 M L King Jr Blvd
New Bern, NC 28562-4238
Phone (252) 637-0093

317 Western Blvd
Jacksonville, NC 28546-6338
Phone (336) 274-6682

702 Newman Rd
New Bern, NC 28562-5238
Phone (336) 274-6682

722 Newman Rd
New Bern, NC 28562-5238
Phone (336) 274-6682

730 Newman Rd
New Bern, NC 28562-5238
Phone (336) 274-6682

738 Newman Rd
New Bern, NC 28562-5238
Phone (336) 274-6682

900 Medical Park Ave
New Bern, NC 28562-5248
Phone (252) 639-5959

Hospital & facility affiliations

  • Carolina East Medical Center Hospital, New Bern, NC, CCN 340131
  • Onslow Memorial Hospital Hospital, Jacksonville, NC, CCN 340042
  • Carteret General Hospital Hospital, Morehead City, NC, CCN 340142

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1680SCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Radiology Associates, PLLC Diagnostic Radiology CurrentSince Oct 9, 2018 Accepting new patients
Coastal Carolina Health Care PA Current Accepting new patients
Greensboro Radiology, PA Diagnostic Radiology CurrentSince Sep 1, 2020 Accepting new patients
Coastal Carolina Health Care PA CurrentSince Jan 1, 2019 Accepting new patients
Coastal Carolina Health Care PA Diagnostic Radiology CurrentSince Jan 1, 2019 Accepting new patients
Coastal Carolina Health Care PA Current Accepting new patients

Locations

1331 N Elm St
Ste 200
Greensboro, NC 27401
Phone (336) 274-4285

1020 Medical Park Ave
New Bern, NC 28562
Phone (252) 514-6685

1030 Medical Park Ave
New Bern, NC 28562
Phone (252) 637-5480

720 Newman Rd
New Bern, NC 28562
Phone (252) 638-3885

2000 Neuse Blvd
New Bern, NC 28560
Phone (252) 633-8104

1040 Medical Park Ave
New Bern, NC 28562
Phone (252) 633-1678

Organizations & group practices 7

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 3

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": "1343174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1689920878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258908",
            "telephone_number": "843-792-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258905",
            "telephone_number": "843-792-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANMIDDLESWORTH",
        "first_name": "KYLE",
        "middle_name": "ALAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-25",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "SC",
            "license": "1680",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "1680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.