Kim James Masters, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

15205 Issued in SC

Practice address

200 Ermine Rd
West Columbia, SC 29170-2024

Phone

(803) 791-9918

Fax

(803) 926-5925

NPI assigned

Jun 26, 2005

Last updated

Oct 27, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Focus Healthcare of Georgia

  • Psychiatric Hospital
  • St Simons Island, GA
  • NPI 1669453783
  NPD (past)

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

{
    "created_epoch": "1119744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225065600000",
    "number": "1902802796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3328",
            "city": "TEGA CAY",
            "state": "SC",
            "postal_code": "297083328",
            "telephone_number": "803-396-2130",
            "fax_number": "803-396-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ERMINE RD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291702024",
            "telephone_number": "803-791-9918",
            "fax_number": "803-926-5925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTERS",
        "first_name": "KIM",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-26",
        "last_updated": "2008-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "SC",
            "license": "15205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Uhrhan Martin, OTR
• Whitney Crain Martin, DO
• Mary S Boyd MD LLC
• Trent Masselink, CRNA
• Jean A Massey, ANP-BC
• Noah Andrew Masters, DO
• Matrix Rehabilitation -South Carolina Inc (Vaughn, Buchanan, Shelley & Associates)
• Matters of the Mind Consulting, LLC
• Melody T Mattox, PTA
• James K Mauchley, DO

• Child & Adolescent Psychiatry Physician in West Columbia, SC
• Providers in West Columbia, SC by specialty
• Child & Adolescent Psychiatry Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.