Individual provider Active NPI

Kayla Jo Nix Medlin, APRN

  • Family Nurse Practitioner
  • Williston, SC
National Provider Identifier
1912624206
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26729 Issued in SC
Practice address
13649 Church St
Williston, SC 29853-5829
Phone
(803) 266-0060
NPI assigned
Oct 26, 2022
Last updated
Aug 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26729 SC Primary

Addresses

Primary practice location

13649 Church St
Williston, SC 29853-5829

Mailing address

86 Wren St
Barnwell, SC 29812-1529
Phone (803) 259-5762

Other identifiers 3

IdentifierTypeStateIssuer
S1264686OtherSCMEDICARE
26729OtherSCSTATE APRN LICENSE
101027013OtherSCDRIVERS LICENSE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230424000654 SC Practitioner - Nurse Practitioner 8921463167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
F. Marion Dwight, MD,PAGroup PAC ID 7214907922, 7 clinicians

Practice addresses (Care Compare)

2113 Main Hwy
Bamberg, SC 29003-2705
Phone 8032455168117

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
F. Marion Dwight, MD,PA CurrentSince Mar 13, 2023 Accepting new patients
F Marion Dwight MD PA PastSince Oct 30, 2022 Accepting new patients

Locations

2113 Main Hwy
Bamberg, SC 29003
Phone (803) 245-5168

Organizations & group practices 2

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 6

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": "1666742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1912624206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 WREN ST",
            "city": "BARNWELL",
            "state": "SC",
            "postal_code": "298121529",
            "telephone_number": "803-259-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13649 CHURCH ST",
            "city": "WILLISTON",
            "state": "SC",
            "postal_code": "298535829",
            "telephone_number": "803-266-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDLIN",
        "first_name": "KAYLA JO",
        "middle_name": "NIX",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-26",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "26729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "S1264686",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE APRN LICENSE",
            "identifier": "26729",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "101027013",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williston, SC

Sources for this page

Verify at the official NPI Registry.