Individual provider Active NPI

Keri Rexroad, NP

  • Family Nurse Practitioner
  • Simpsonville, SC
National Provider Identifier
1942639364
Registry record updated Jul 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20358 Issued in SC
Practice address
3930 Grandview Dr
Simpsonville, SC 29680-3163
Phone
(864) 757-5059
NPI assigned
Nov 6, 2013
Last updated
Jul 26, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2016

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 20358 SC Primary

Addresses

Primary practice location

3930 Grandview Dr
Simpsonville, SC 29680-3163

Mailing address

3930 Grandview Dr
Simpsonville, SC 29680-3163
Phone (864) 757-5059

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
I20160927002711 SC Practitioner - Nurse Practitioner 3870880370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bon Secours Ambulatory Services - St. Francis, LLCGroup PAC ID 0840590931, 57 clinicians

Practice addresses (Care Compare)

3710 Clemson Blvd
Anderson, SC 29621-1317
Phone (864) 757-5059

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20358SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Woodruff Road Urgent Care Center, P.C. PastSince Dec 29, 2019 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1383696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469491200000",
    "number": "1942639364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 GRANDVIEW DR",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296803163",
            "telephone_number": "864-757-5059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 GRANDVIEW DR",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296803163",
            "telephone_number": "864-757-5059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REXROAD",
        "first_name": "KERI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-06",
        "last_updated": "2016-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "20358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simpsonville, SC

Sources for this page

Verify at the official NPI Registry.