Individual provider Active NPI

Tiffany G McKeel, APRN

  • Family Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1780828293
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3900 Issued in SC
Practice address
111 Doctor Cir
Columbia, SC 29203-6502
Phone
(800) 491-0909
NPI assigned
Apr 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3900 SC Primary

Addresses

Primary practice location

111 Doctor Cir
Columbia, SC 29203-6502

Mailing address

111 Doctor Cir
Columbia, SC 29203-6502
Phone (800) 491-0909

Other identifiers 3

IdentifierTypeStateIssuer
NP1428MedicaidSC
GP1551OtherSCMEDICAID GROUP #
P00883445OtherSCMEDICARE RAILROAD

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
I20090616000558 SC Practitioner - Nurse Practitioner 8123178944 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3900SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Healthcare of Charleston LLC CurrentSince Apr 24, 2023 Accepting new patients
Palmetto Primary Care Physicians, LLC CurrentSince Jun 1, 2009 Accepting new patients
Palmetto Primary Care Physicians, LLC CurrentSince Jun 1, 2009 Accepting new patients
Palmetto Primary Care Physicians, LLC Current Accepting new patients
SC House Calls Inc CurrentSince May 30, 2022 Accepting new patients
SC House Calls Inc CurrentSince May 30, 2022 Accepting new patients
Gray'S Pain Relief Center, LLC PastSince Apr 24, 2023 Accepting new patients
James T. Martin Jr. MD PastSince May 1, 2006 Accepting new patients

Locations

1401 Main St
Bonneau, SC 29431
Phone (843) 825-3404

776 Daniel Ellis Dr
Ste 1B
Charleston, SC 29412
Phone (843) 795-0300

1624 Main St
Columbia, SC 29201
Phone (803) 454-0365

111 Doctor Cir
Columbia, SC 29203
Phone (803) 730-8910

122 S Goose Creek Blvd
#B
Goose Creek, SC 29445
Phone (843) 553-2211

3495 Iron Horse Rd
Ladson, SC 29456
Phone (843) 793-5970

2550 Elms Center Rd
North Charleston, SC 29406
Phone (843) 302-8840

2039 N Main St
Summerville, SC 29486
Phone (843) 225-1809

201 Sigma Dr
Ste 100
Summerville, SC 29486
Phone (843) 820-3397

1053 Center St
West Columbia, SC 29169
Phone (803) 454-0365

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.654

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": "1240876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1780828293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 DOCTOR CIR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036502",
            "telephone_number": "800-491-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DOCTOR CIR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036502",
            "telephone_number": "800-491-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEEL",
        "first_name": "TIFFANY",
        "middle_name": "G",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-28",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "3900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP1428",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP #",
            "identifier": "GP1551",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00883445",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.