NPIMap

Individual provider Active NPI

Kinchen Ballentine, MD

  • Body Imaging Physician
  • Abbeville, SC
National Provider Identifier
1710046644
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Body Imaging PhysicianTaxonomy code 2085B0100X
License
HTL-098 Issued in SC
Practice address
420 Thomson Cir
Abbeville, SC 29620
Phone
(864) 366-5011
Fax
(864) 366-3343
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X HTL-098 SC Primary

Addresses

Primary practice location

420 Thomson Cir
Abbeville, SC 29620

Mailing address

P O Box 887
Abbeville, SC 29620
Phone (864) 366-5011

Other identifiers 1

IdentifierTypeStateIssuer
N17751MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120718000642 TX Practitioner - Diagnostic RadiologyPractitioner - Nuclear Medicine 5890701445 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
HTL-098SCMDBody Imaging Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Jun 7, 2012 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital Current Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Jun 7, 2012 Accepting new patients
K. W. Ballentine, MD, PA PastSince Mar 6, 2006 Accepting new patients

Locations

6 Road 7586
Bloomfield, NM 87413
Phone (505) 368-8015

Organizations & group practices 5

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 7

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

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Tennessee, HSC, College of Medicine, 1967
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DHHS PHS Naihs Shiprock Hospital 148 clinicians

Practice addresses (Care Compare)

6 Rd
Suite 7586
Bloomfield, NM 87413-4934
Phone (505) 368-6401

Highway 491
Shiprock, NM 87420-0160
Phone 50536860016401

P O Box
160 Attn Business Office
Shiprock, NM 87420-0160

PO Box
Suite 160
Shiprock, NM 87420-0160

US Hwy 160 and Navajo Route 35-Red Mesa
Teecnospos, AZ 86514
Phone (928) 656-5165

Hospital & facility affiliations

  • Northern Navajo Medical Center Hospital, Shiprock, NM, CCN 320059
  • San Juan Regional Medical Center Inc Hospital, Farmington, NM, CCN 320005

Merit-based Incentive Payment System (MIPS)

Final score
84.26 of 100Reported as group
Quality
74.27
Improvement activities
40
Cost
78.06

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1710046644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 887",
            "city": "ABBEVILLE",
            "state": "SC",
            "postal_code": "29620",
            "telephone_number": "864-366-5011",
            "fax_number": "864-366-3343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 THOMSON CIR",
            "city": "ABBEVILLE",
            "state": "SC",
            "postal_code": "29620",
            "telephone_number": "864-366-5011",
            "fax_number": "864-366-3343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLENTINE",
        "first_name": "KINCHEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "SC",
            "license": "HTL-098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N17751",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abbeville, SC

Sources for this page

Verify at the official NPI Registry.