Individual provider Active NPI

Keith S. Rockwiley, PA

  • Medical Physician Assistant
  • Dillon, SC
National Provider Identifier
1750471967
Registry record updated Jan 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C0002414 Issued in MD
Practice address
301 E Jackson St
Emergency Dept.
Dillon, SC 29536-2509
Phone
(843) 774-4111
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C0002414 MD Primary

Addresses

Primary practice location

301 E Jackson St
Emergency Dept.
Dillon, SC 29536-2509

Mailing address

2849 Dogwood Rd
Timmonsville, SC 29161-8614
Phone (843) 346-1035

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
I20081124000249 SC Practitioner - Physician Assistant 3274693015 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
80.41 of 100Reported as group
Quality
64.93
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1377SCMDOptometrist
C0002414MDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scotland Memorial Hospital Inc CurrentSince Jan 1, 2015 Accepting new patients
Musc Community Physicians CurrentSince Aug 23, 2023 Accepting new patients
Musc Community Physicians CurrentSince Aug 23, 2023 Accepting new patients
Scotland Memorial Hospital Inc CurrentSince Jan 1, 2015 Accepting new patients
Pee Dee Emergency Physicians Past Accepting new patients
Midatlantic Cardiovascular Associates PA Past Accepting new patients

Locations

500 Lauchwood Dr
Laurinburg, NC 28352
Phone (856) 848-3227

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

Interoperability endpoints

  • Direct secure messaging: krockwiley92352@directmcleodehealth.org
  • Direct secure messaging: krockwiley380096@direct.musc.edu

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421280000000",
    "number": "1750471967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2849 DOGWOOD RD",
            "city": "TIMMONSVILLE",
            "state": "SC",
            "postal_code": "291618614",
            "telephone_number": "843-346-1035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E JACKSON ST",
            "address_2": "EMERGENCY DEPT.",
            "city": "DILLON",
            "state": "SC",
            "postal_code": "295362509",
            "telephone_number": "843-774-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCKWILEY",
        "first_name": "KEITH",
        "middle_name": "S.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2015-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0002414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dillon, SC

Sources for this page

Verify at the official NPI Registry.