Individual provider Active NPI

Kelly G Svedberg, PA-C

  • Physician Assistant
  • Rock Hill, SC
National Provider Identifier
1790838621
Registry record updated Oct 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1575 Issued in SC
Practice address
2424 India Hook Rd Ste 120
Rock Hill, SC 29732-1278
Phone
(704) 350-5885
Fax
(936) 244-4599
NPI assigned
Jan 22, 2007
Last updated
Oct 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-00631 NC
Physician Assistant 363A00000X PA10819 TX
Physician Assistant 363A00000X PA1575 SC Primary

Addresses

Primary practice location

2424 India Hook Rd Ste 120
Rock Hill, SC 29732-1278

Mailing address

7819 Jaars Rd
Waxhaw, NC 28173-7677
Phone (704) 350-5885

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
I20181210000755 SC Practitioner - Physician Assistant 0143320077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

331 E Main St
Suite 200
Rock Hill, SC 29730-5384
Phone (704) 350-5885

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-00631NCMDPhysician Assistant
PA1575SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mind Wellness Clinic Single Specialty CurrentSince Sep 28, 2021 Accepting new patients
Pain Management Associates, P.a. Single Specialty Past Accepting new patients
Tega Cay Psychiatric Associates, PA Single Specialty Past Accepting new patients
The Saluda Counseling Services Center Inc. Single Specialty PastSince Sep 1, 2019 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790899200000",
    "number": "1790838621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7819 JAARS RD",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281737677",
            "telephone_number": "704-350-5885",
            "fax_number": "936-244-4599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 INDIA HOOK RD STE 120",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321278",
            "telephone_number": "704-350-5885",
            "fax_number": "936-244-4599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SVEDBERG",
        "first_name": "KELLY",
        "middle_name": "G",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-00631",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA10819",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "PA1575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.