NPIMap

Individual provider Active NPI

Kelley Banagan, MD

  • Orthopaedic Surgery of the Spine Physician
  • Charleston, SC
National Provider Identifier
1851435408
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
MD93962 Issued in SC
Practice address
96 Jonathan Lucas Street CSB 708 MSC 622
Charleston, SC 29425-1544
Phone
(843) 792-8105
NPI assigned
Feb 16, 2007
Last updated
Apr 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X D72819 MD
Orthopaedic Surgery of the Spine Physician 207XS0117X MD93962 SC Primary

Addresses

Primary practice location

96 Jonathan Lucas Street CSB 708 MSC 622
Charleston, SC 29425-1544

Mailing address

PO Box 751461
Charlotte, NC 28275-1461

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.musc.edu Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, 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
I20190724003901 NY Practitioner - Orthopedic Surgery 3577734854 Reassigns benefits to 1 organization
I20250428000236 SC Practitioner - Orthopedic Surgery 3577734854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2005
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

Merit-based Incentive Payment System (MIPS)

Final score
82.41 of 100Reported as group
Quality
56.02
Promoting interoperability
100
Improvement activities
40
Cost
85.34

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion12
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol CurrentSince Mar 10, 2025 Accepting new patients
Capital Region Orthopaedic Associates, PC Orthopaedic Surgery of the Spine CurrentSince Jul 29, 2019 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Mar 10, 2025 Accepting new patients
Baltimore Washington Professional Services Inc Orthopaedic Surgery of the Spine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1367 Washington Ave
Ste 200
Albany, NY 12206
Phone (518) 489-2666

146 Jefferson Hts
Ste 101
Catskill, NY 12414
Phone (518) 943-0667

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

96 Jonathan Lucas St
#708
Charleston, SC 29425
Phone (843) 792-0245

Interoperability endpoints

  • Direct secure messaging: kbanagan529009@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1851435408",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 JONATHAN LUCAS STREET CSB 708 MSC 622",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294251544",
            "telephone_number": "843-792-8105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANAGAN",
        "first_name": "KELLEY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "MD",
            "license": "D72819",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "SC",
            "license": "MD93962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "96 Jonathan Lucas Street Csb 708 Msc 622",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294251544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.