NPIMap

Individual provider Active NPI

Kimberly Caraway Dubose, M.D.

  • Obstetrics & Gynecology Physician
  • Greenville, SC
National Provider Identifier
1770510547
Registry record updated Aug 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
23661 Issued in SC
Practice address
890 W Faris Rd
Suite 330
Greenville, SC 29605-4247
Phone
(864) 233-1112
Fax
(864) 233-1204
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 23661 SC Primary

Addresses

Primary practice location

890 W Faris Rd
Suite 330
Greenville, SC 29605-4247

Mailing address

1 Independence PT
Suite 212
Greenville, SC 29615-4545
Phone (864) 797-6044

Other identifiers 4

IdentifierTypeStateIssuer
571004971010OtherSCBCBS OF SC
236612MedicaidSC
7058496OtherSCAETNA
P00038933OtherSCRR MEDICARE

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
I20031222000291 SC Practitioner - Obstetrics/Gynecology 3173421740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of South Carolina School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

890 W Faris Rd
Suite 330
Greenville, SC 29605-4281
Phone (864) 455-1270

Hospital & facility affiliations

  • Prisma Health Patewood Hospital Hospital, Greenville, SC, CCN 420102
  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078
  • St Francis-Downtown Hospital, Greenville, SC, CCN 420023
  • Prisma Health North Greenville Ltach Long-term care hospital, Travelers Rest, SC, CCN 422008

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23661SCMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group Obstetrics & Gynecology CurrentSince Jan 1, 2008 Accepting new patients
Prisma Health University Medical Group CurrentSince Jan 1, 2008 Accepting new patients
Greenville Proaxis Therapy, LLC Past Accepting new patients
Greenville Health System Past Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

890 W Faris Rd
Ste 330
Greenville, SC 29605
Phone (864) 233-1112

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

877 W Faris Rd
Ste C
Greenville, SC 29605
Phone (864) 455-8147

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

100 Augusta St
Greenville, SC 29601
Phone (864) 455-2600

Interoperability endpoints

  • Direct secure messaging: kdubose11688@direct.ghs.myhfn.org

Organizations & group practices 4

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 51

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

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375401600000",
    "number": "1770510547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT",
            "address_2": "SUITE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154545",
            "telephone_number": "864-797-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 W FARIS RD",
            "address_2": "SUITE 330",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054247",
            "telephone_number": "864-233-1112",
            "fax_number": "864-233-1204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOSE",
        "first_name": "KIMBERLY",
        "middle_name": "CARAWAY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2013-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "23661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF SC",
            "identifier": "571004971010",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "236612",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7058496",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00038933",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.