Individual provider Active NPI

Sherri L Keelor, FNP-BC

  • Family Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1790038651
Registry record updated Mar 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
55303 Issued in WV
Practice address
1410 Blanding St
Columbia, SC 29201-2967
Phone
(803) 849-2476
Fax
(803) 758-1726
NPI assigned
Oct 16, 2012
Last updated
Mar 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2020

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 55303 WV Primary

Addresses

Primary practice location

1410 Blanding St
Columbia, SC 29201-2967

Mailing address

2133 Walker Solomon Way
Columbia, SC 29204-1131
Phone (803) 849-2476

Other identifiers 1

IdentifierTypeStateIssuer
1790038651OtherSCNPI

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
I20191219002915 SC Practitioner - Nurse Practitioner 9436389277 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands CurrentSince Jan 20, 2020 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Jan 20, 2020 Accepting new patients

Locations

1410 Blanding St
Ste 102
Columbia, SC 29201
Phone (803) 256-2500

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583452800000",
    "number": "1790038651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2133 WALKER SOLOMON WAY",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292041131",
            "telephone_number": "803-849-2476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 BLANDING ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012967",
            "telephone_number": "803-849-2476",
            "fax_number": "803-758-1726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEELOR",
        "first_name": "SHERRI",
        "middle_name": "L",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-16",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "55303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1790038651",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.