Individual provider Active NPI

Kailyn M Wilcox, M.D.

  • Plastic Surgery Physician
  • Summerville, SC
National Provider Identifier
1972914703
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
MD93282 Issued in SC
Practice address
218 Brighton Park Blvd Ste 101
Summerville, SC 29486-3013
Phone
(843) 264-7973
NPI assigned
May 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X MD93282 SC Primary

Addresses

Primary practice location

218 Brighton Park Blvd Ste 101
Summerville, SC 29486-3013

Mailing address

218 Brighton Park Blvd Ste 101
Summerville, SC 29486-3013
Phone (843) 264-7973

Other practice location 1

20 Fairchild St Unit 102
Daniel Island, SC 29492-8952
Phone (843) 264-7973

Other practice location 2

1014 Saint Andrews Blvd Ste 310
Charleston, SC 29407-7177
Phone (843) 264-7973

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
I20250417000993 SC Practitioner - Plastic and Reconstructive Surgery 5991041758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
State University of Ny Upstate Medical University, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

218 Brighton Park Blvd
Suite 101
Summerville, SC 29486-3013
Phone (843) 471-1135

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD93282SCMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dennis Schimpf PC CurrentSince Apr 1, 2025 Accepting new patients

Locations

1014 Saint Andrews Blvd
Ste 310
Charleston, SC 29407
Phone (843) 264-7973

20 Fairchild St
Unit 102
Daniel Island, SC 29492
Phone (843) 264-7973

218 Brighton Park Blvd
Ste 101
Summerville, SC 29486
Phone (843) 264-7973

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1972914703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 BRIGHTON PARK BLVD STE 101",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294863013",
            "telephone_number": "843-264-7973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 BRIGHTON PARK BLVD STE 101",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294863013",
            "telephone_number": "843-264-7973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Fairchild St Unit 102",
            "address_purpose": "LOCATION",
            "city": "Daniel Island",
            "state": "SC",
            "postal_code": "294928952",
            "country_code": "US",
            "telephone_number": "843-264-7973",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1014 Saint Andrews Blvd Ste 310",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294077177",
            "country_code": "US",
            "telephone_number": "843-264-7973",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "KAILYN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-14",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "SC",
            "license": "MD93282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.