Individual provider Active NPI

Eammon Kiyomura, MD

  • Emergency Medicine Physician
  • Greenville, SC
National Provider Identifier
1841094877
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
1841094877 Issued in SC
Practice address
876 W Faris Rd
Greenville, SC 29605-4253
Phone
(864) 455-5648
NPI assigned
Apr 1, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X 1841094877 SC Primary

Addresses

Primary practice location

876 W Faris Rd
Greenville, SC 29605-4253

Mailing address

876 W Faris Rd
Greenville, SC 29605-4253

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250805002545 SC Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 3072021534

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1841094877SCMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1743465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1841094877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "876 W FARIS RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "876 W FARIS RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054253",
            "telephone_number": "864-455-5648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIYOMURA",
        "first_name": "EAMMON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-01",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "1841094877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.