Individual provider Active NPI

Keith Howard Pernie, MD

  • Anesthesiology Physician
  • Greenville, SC
National Provider Identifier
1902843741
Registry record updated Feb 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
27603 Issued in SC
Practice address
67 Creekside Park CT
Greenville, SC 29615-4810
Phone
(864) 242-4602
Fax
(864) 242-0129
NPI assigned
Jun 1, 2006
Last updated
Feb 23, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 27603 SC Primary

Addresses

Primary practice location

67 Creekside Park CT
Greenville, SC 29615-4810

Mailing address

1 Independence PT Ste 212
Greenville, SC 29615-4536
Phone (864) 797-6015

Other identifiers 1

IdentifierTypeStateIssuer
N01540MedicaidSC

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
I20140910000695 SC Practitioner - Anesthesiology 8729040787 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Wayne State University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

22725 Hwy 76 E
Clinton, SC 29325-7527
Phone (864) 833-4545

22725 US Hwy 76
Suite 3C
Clinton, SC 29325-7527
Phone (864) 833-3852

67 Creekside Park CT
Greenville, SC 29615-4810
Phone (864) 522-3700

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jan 1, 2015 Accepting new patients
Greenville Health System CurrentSince Jan 1, 2015 Accepting new patients
Prisma Health University Medical Group Current Accepting new patients
Prisma Health University Medical Group Anesthesiology CurrentSince Jan 1, 2015 Accepting new patients
Greenville Health System Current Accepting new patients
Anesthetix of Lexington, PLLC Anesthesiology Past Accepting new patients
Carolina Anesthesia Group PLLC Anesthesiology Past Accepting new patients
Oban Anesthesia Consultants, PLLC Anesthesiology Past Accepting new patients

Locations

22725 US Highway 76
Clinton, SC 29325
Phone (864) 833-9100

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

100 Augusta St
Greenville, SC 29601
Phone (864) 455-2600

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

67 Creekside Park Ct
Greenville, SC 29615
Phone (864) 242-4602

701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030

315 Medical Pkwy
Ste 200
Greer, SC 29650
Phone (864) 797-9550

298 Memorial Dr
Seneca, SC 29672
Phone (864) 482-3100

719A SE Main St
Simpsonville, SC 29681
Phone (864) 967-9000

807 N Main St
Travelers Rst, SC 29690
Phone (864) 834-5132

Interoperability endpoints

  • Direct secure messaging: kpernie21304@direct.ghs.myhfn.org

Organizations & group practices 8

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 1

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519344000000",
    "number": "1902843741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT STE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154536",
            "telephone_number": "864-797-6015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 CREEKSIDE PARK CT",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154810",
            "telephone_number": "864-242-4602",
            "fax_number": "864-242-0129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERNIE",
        "first_name": "KEITH",
        "middle_name": "HOWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2018-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SC",
            "license": "27603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N01540",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.