NPIMap

Individual provider Active NPI

Kenneth M Faile Jr., MD

  • Family Medicine Physician
  • Johnsonville, SC
National Provider Identifier
1750354858
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19643 Issued in SC
Practice address
355 S. Georgetown Hwy
Johnsonville, SC 29555
Phone
(843) 380-2000
Fax
(843) 380-2014
NPI assigned
Feb 9, 2006
Last updated
Feb 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 19643 SC Primary

Addresses

Primary practice location

355 S. Georgetown Hwy
Johnsonville, SC 29555

Mailing address

PO Box 3239
Florence, SC 29502-3239
Phone (843) 380-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kenneth.faile@mpaii.eclinicaldirectplus.com Direct

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
I20061218000428 SC Practitioner - Family Practice 0244239366 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical University of South Carolina College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLeod Physician Associates IIGroup PAC ID 8224031307, 541 clinicians

Practice addresses (Care Compare)

2437 Willwood Dr
Florence, SC 29501-3904
Phone (843) 777-3100

3013 A W Palmetto St
Florence, SC 29501-5935

3015 W Palmetto St
Florence, SC 29501-5935
Phone (843) 777-6870

800 E Cheves St
Florence, SC 29506-2650

800 E Cheves St
Florence, SC 29506-2652

964 Lochend Dr
Darlington, SC 29532-5698
Phone (843) 777-6890

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Health Clarendon Family Medicine CurrentSince Apr 23, 2020 Accepting new patients
McLeod Physician Associates II CurrentSince Oct 1, 2006 Accepting new patients
McLeod Health Clarendon Family Medicine CurrentSince Apr 23, 2020 Accepting new patients
McLeod Health Clarendon Current Accepting new patients
McLeod Physician Associates II Family Medicine Current Accepting new patients
McLeod Physician Associates II CurrentSince Oct 1, 2006 Accepting new patients
McLeod Physician Associates II Family Medicine Past Accepting new patients

Locations

2437 Willwood Dr
Florence, SC 29501
Phone (843) 777-3000

555 E Cheves St
Florence, SC 29506
Phone (843) 662-5233

800 E Cheves St
Ste 240
Florence, SC 29506
Phone (843) 777-7950

800 E Cheves St
Ste 480A
Florence, SC 29506
Phone (843) 777-7337

355 S Georgetown Hwy
Johnsonville, SC 29555
Phone (843) 380-2000

10 E Hospital St
Manning, SC 29102
Phone (803) 433-3000

Interoperability endpoints

  • Direct secure messaging: kenneth.faile@mpaii.eclinicaldirectplus.com
  • Direct secure messaging: kfaile41144@directmcleodehealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1750354858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3239",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295023239",
            "telephone_number": "843-380-2000",
            "fax_number": "843-380-2014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 S. GEORGETOWN HWY",
            "city": "JOHNSONVILLE",
            "state": "SC",
            "postal_code": "29555",
            "telephone_number": "843-380-2000",
            "fax_number": "843-380-2014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAILE",
        "first_name": "KENNETH",
        "middle_name": "M",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "19643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kenneth.faile@mpaii.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "ECW DA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EHR",
            "address_1": "355 S. Georgetown Hwy",
            "city": "Johnsonville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "29555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Johnsonville, SC

Sources for this page

Verify at the official NPI Registry.