Individual provider Active NPI

Kwajaleyn Herbresha Myers, FNP

  • Family Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1831843820
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
25324 Issued in SC
Practice address
4621 Hard Scrabble Rd
Columbia, SC 29229-8584
Phone
(803) 736-8955
NPI assigned
Feb 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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 25324 SC Primary

Addresses

Primary practice location

4621 Hard Scrabble Rd
Columbia, SC 29229-8584

Mailing address

PO Box 749306
Atlanta, GA 30374-9306

Other practice location 1

1325 Spring St
Greenwood, SC 29646-3860
Phone (864) 725-4217

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
I20220526001932 SC Practitioner - Nurse Practitioner 3375921752 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Urgent Cares LLCGroup PAC ID 8628502598, 183 clinicians

Practice addresses (Care Compare)

4621 Hard Scrabble Rd
Columbia, SC 29229-8584
Phone (803) 736-8955

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25324SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eminent Medical Services LLC Family Current Accepting new patients
Lowcountry Urgent Care LLC CurrentSince Jun 15, 2022 Accepting new patients
Novant Health Urgent Cares LLC CurrentSince Nov 1, 2024 Accepting new patients

Locations

6167 Braided Mane Pass SW
Aiken, SC 29803
Phone (803) 502-1484

182C Sea Island Pkwy
Beaufort, SC 29907
Phone (843) 322-1933

2010 W DeKalb St
Camden, SC 29020
Phone (803) 272-0500

100 Jimmy Love Ln
Columbia, SC 29212
Phone (803) 731-4055

4621 Hard Scrabble Rd
Columbia, SC 29229
Phone (803) 736-8955

Interoperability endpoints

  • Direct secure messaging: kmyers535358@selfregional.direct-ci.net

Organizations & group practices 3

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": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1831843820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749306",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4621 HARD SCRABBLE RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292298584",
            "telephone_number": "803-736-8955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1325 Spring St",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "SC",
            "postal_code": "296463860",
            "country_code": "US",
            "telephone_number": "864-725-4217",
            "fax_number": "864-725-4217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYERS",
        "first_name": "KWAJALEYN",
        "middle_name": "HERBRESHA",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-08",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "25324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.