Active NPI
Kevin Arthur Polley, MD
- Pediatric Emergency Medicine (Pediatrics) Physician
- Greenville, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Emergency Medicine (Pediatrics) Physician
- License
- 18709
- Practice address
- 701 Grove Rd FL 1
Greenville, SC 29605-4210 - Phone
- (864) 455-7899
- Fax
- (864) 455-5474
- NPI assigned
- Sep 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Emergency Medicine (Pediatrics) Physician | 2080P0204X | 18709 | SC | Primary |
| Pediatric Emergency Medicine (Emergency Medicine) Physician | 207PP0204X | 18709 | SC |
Addresses
Primary practice location
701 Grove Rd FL 1
Greenville, SC 29605-4210
Mailing address
300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 187096 | Medicaid | SC | |
| 576007863 | Other | SC | AETNA |
| 576007863 | Other | SC | UHC |
| 20009601 | Other | SC | SELECT HEALTH |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18709 | SC | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prisma Health University Medical Group | Current | Accepting new patients | |
| Pathology Associates of Greenville PA | Current | Accepting new patients | |
| Prisma Health-Upstate | Current | Accepting new patients | |
| Prisma Health University Medical Group | Current | Accepting new patients | |
| Prisma Health-Upstate | Current | Accepting new patients | |
| Prisma Health-Upstate | Current | Accepting new patients |
Locations
22725 US Highway 76
Clinton, SC 29325
Phone (864) 833-9100
210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123
100 Augusta St
Greenville, SC 29601
Phone (864) 455-2600
701 Grove Rd
Fl 1
Greenville, SC 29605
Phone (864) 455-7899
701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030
255 Enterprise Blvd
Ste 250
Greenville, SC 29615
Phone (864) 454-0886
1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306
300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615
830 S Buncombe Rd
Greer, SC 29650
Phone (864) 797-8000
298 Memorial Dr
Seneca, SC 29672
Phone (864) 482-3100
729 SE Main St
Simpsonville, SC 29681
Phone (864) 271-8647
807 N Main St
Travelers Rst, SC 29690
Phone (864) 834-5132
Interoperability endpoints
- kpolley21297@direct.ghs.myhfn.org
Organizations & group practices 6
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.
-
- Family Medicine Physician
- Greenville, SC
- NPI 1295763217
-
dba Prisma Health Greenville Memorial Hospital
- General Acute Care Hospital
- Greenville, SC
- NPI 1649726738
-
- Anatomic Pathology & Clinical Pathology Physician
- Greenville, SC
- NPI 1831151976
-
dba Parkside OB-GYN
- Gynecology Physician
- Greer, SC
- NPI 1003619313
-
dba Prisma Health Laurens County Hospital
- General Acute Care Hospital
- Clinton, SC
- NPI 1245786367
-
dba Prisma Health Wonder Center-Non Medicaid
- Medically Fragile Infants and Children Day Care
- Greenville, SC
- NPI 1811439649
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1912007535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 E MCBEE AVE FL 4",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296012842",
"telephone_number": "864-522-8603",
"fax_number": "864-454-1130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 GROVE RD FL 1",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296054210",
"telephone_number": "864-455-7899",
"fax_number": "864-455-5474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLLEY",
"first_name": "KEVIN",
"middle_name": "ARTHUR",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-24",
"last_updated": "2023-03-07",
"certification_date": "2022-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0204X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Emergency Medicine",
"state": "SC",
"license": "18709",
"primary": true
},
{
"code": "207PP0204X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Pediatric Emergency Medicine",
"state": "SC",
"license": "18709",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "187096",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "576007863",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC",
"identifier": "576007863",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SELECT HEALTH",
"identifier": "20009601",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.