Kaylee Quattlebaum, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4659 Issued in SC

Practice address

102 Rockcreek Blvd
Greenwood, SC 29649-8915

Phone

(864) 725-5020

NPI assigned

Nov 2, 2022

Sex

Female

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

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Self Regional HealthcareGroup PAC ID 4082527742, 159 clinicians

Self Medical GroupGroup PAC ID 6002953916, 393 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Self Regional Healthcare Hospital, Greenwood, SC, CCN 420071

Merit-based Incentive Payment System (MIPS)

Final score

94.7 of 100Reported as apm

Quality

89.4

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kquattlebaum538848@selfregional.direct-ci.net

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.

• Self Medical Group

  • Surgery Physician
  • Greenwood, SC
  • NPI 1982836847
  Medicare reassignment Care Compare group
• Self Regional Healthcare

  • Family Medicine Physician
  • Greenwood, SC
  • NPI 1326067703
  Medicare reassignment Care Compare group
• Self Medical Group

  • Surgery Physician
  • Greenwood, SC
  • NPI 1457685570
  NPD
• Self Medical Group

  • Diagnostic Radiology Physician
  • Greenwood, SC
  • NPI 1659839694
  NPD
• Self Regional Healthcare

  • Neurology Physician
  • Greenwood, SC
  • NPI 1285502559
  NPD
• Self Regional Healthcare

  • Family Medicine Physician
  • MC Cormick, SC
  • NPI 1467251843
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Self Regional Healthcare

  • Pain Medicine (Anesthesiology) Physician
  • Greenwood, SC
  • NPI 1013867498

  Hospital

  Care Compare affiliation
• Self Regional Healthcare

  • General Acute Care Hospital
  • Greenwood, SC
  • NPI 1023046612
  Care Compare affiliation
• Self Regional Healthcare

  • General Acute Care Hospital
  • Greenwood, SC
  • NPI 1407887003
  Care Compare affiliation
• Self Regional Healthcare

  • Pain Medicine (Anesthesiology) Physician
  • Clinton, SC
  • NPI 1720938103

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1952018525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 ROCKCREEK BLVD",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296498915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 ROCKCREEK BLVD",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296498915",
            "telephone_number": "864-725-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUATTLEBAUM",
        "first_name": "KAYLEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-02",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Providence Foot & Ankle Centers PC
• Provident Health Care LLC
• Alexia Pruitt
• Lori Pruitt, LPC
• Publix Super Markets Inc
• Kristine Michele Rabold, PHARMD
• Shawn Radford
• Ahmad Khalil Rahal, MD
• Albert A Ramage III, MD
• Samuel Tompkins Ramey, DMD

• Physician Assistant in Greenwood, SC
• Providers in Greenwood, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.