NPIMap

Individual provider Active NPI

Keith Franklin Lamar Polston, MD

  • Physical Medicine & Rehabilitation Physician
  • Charleston, SC
National Provider Identifier
1831659168
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
91964 Issued in SC
Practice address
171 Ashley Ave
Charleston, SC 29425-8500
Phone
(843) 792-1414
NPI assigned
Mar 22, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 13298235-1205 UT
Physical Medicine & Rehabilitation Physician 208100000X 91964 SC Primary

Addresses

Primary practice location

171 Ashley Ave
Charleston, SC 29425-8500

Mailing address

PO Box 751461
Charlotte, NC 28275-1461
Phone (843) 792-1414

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kpolston642715@direct.med.utah.edu Direct University of Utah
Direct Messaging Address direct@direct.musc.edu Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230516001771 UT Practitioner - Physical Medicine and Rehabilitation 8325373020 Reassigns benefits to 1 organization
I20240517002942 SC Practitioner - Physical Medicine and Rehabilitation 8325373020 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Tennessee, HSC, College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

Hospital & facility affiliations

  • Musc Medical Center Hospital, Charleston, SC, CCN 420004
  • Tidelands Georgetown Memorial Hospital Hospital, Georgetown, SC, CCN 420020

Merit-based Incentive Payment System (MIPS)

Final score
81.61 of 100Reported as group
Quality
93.24
Promoting interoperability
100
Improvement activities
40
Cost
45.48

Merit-based Incentive Payment System (MIPS)

Final score
79.02 of 100Reported as group
Quality
62.41
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Specialty Services CurrentSince May 1, 2023 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Jun 1, 2024 Accepting new patients
University of Utah Specialty Services Current Accepting new patients
University of Utah Specialty Services Physical Medicine & Rehabilitation CurrentSince May 1, 2023 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Jun 1, 2024 Accepting new patients

Locations

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

2060 Sam Rittenberg Blvd
Charleston, SC 29407
Phone (843) 876-0111

1101 Waterline St
Charleston, SC 29492
Phone (843) 985-4700

1122 Chuck Dawley Blvd
Mt Pleasant, SC 29464
Phone 8438491551112

5500 Front St
Summerville, SC 29486
Phone (843) 712-1414

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Interoperability endpoints

  • Direct secure messaging: kpolston476965@direct.musc.edu

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1831659168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461",
            "telephone_number": "843-792-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258500",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLSTON",
        "first_name": "KEITH",
        "middle_name": "FRANKLIN LAMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-22",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "UT",
            "license": "13298235-1205",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "SC",
            "license": "91964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpolston642715@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "171 Ashley Ave",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294258500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.