Individual provider Active NPI

Kristina Diane Allred, PA-C

  • Physician Assistant
  • Powdersville, SC
National Provider Identifier
1760028393
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3613 SC-153
Powdersville, SC 29611
Phone
(864) 207-4257
NPI assigned
Nov 19, 2019
Last updated
Jan 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

3613 SC-153
Powdersville, SC 29611

Mailing address

506 Birchbark CT
Seneca, SC 29672-0784
Phone (864) 888-3235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200221002311 SC Practitioner - Physician Assistant 1850728346 Reassigns benefits to 2 organizations
I20260622002917 ID Practitioner - Physician Assistant 1850728346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Golden Corner Family PracGroup PAC ID 5799836672, 4 clinicians
Bon Secours Ambulatory Services - St. Francis, LLCGroup PAC ID 0840590931, 57 clinicians

Practice addresses (Care Compare)

1205 N Hwy 11
West Union, SC 29696-2715
Phone (864) 638-5402

13400 Clemson Blvd
Seneca, SC 29678-1455
Phone (864) 757-5059

1467 Woodruff Rd
Suite C
Greenville, SC 29607-6505
Phone (864) 458-8126

3613 Hwy 153
Greenville, SC 29611-7516
Phone (864) 757-5059

3710 Clemson Blvd
Anderson, SC 29621-1317
Phone (864) 757-5059

5208 Calhoun Memorial Hwy
Suite C
Easley, SC 29640-3864
Phone (864) 757-5059

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Ambulatory Services - St. Francis, LLC CurrentSince Mar 1, 2023 Accepting new patients
Booker Family Practice, LLC Past Accepting new patients
Woodruff Road Urgent Care Center, P.C. PastSince Dec 29, 2019 Accepting new patients

Locations

5208 Calhoun Memorial Hwy
#C
Easley, SC 29640
Phone (864) 307-8672

1467 Woodruff Rd
Ste C
Greenville, SC 29607
Phone (864) 458-8126

3613 Highway 153
Powdersville, SC 29611
Phone (864) 207-4257

Interoperability endpoints

  • Direct secure messaging: kallred627693@direct.ghs.myhfn.org

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

Hospital & facility affiliations 5

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": "1574121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1760028393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 BIRCHBARK CT",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296720784",
            "telephone_number": "864-888-3235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3613 SC-153",
            "city": "POWDERSVILLE",
            "state": "SC",
            "postal_code": "29611",
            "telephone_number": "864-207-4257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLRED",
        "first_name": "KRISTINA",
        "middle_name": "DIANE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-19",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Powdersville, SC

Sources for this page

Verify at the official NPI Registry.