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MRS. KELLY MARTIN WILSON PA-C NPI 1396933461


NPI Information

NPI: 1396933461
Provider Name: MRS. KELLY MARTIN WILSON, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
1330 BOILING SPRINGS RD
SUITE 1600
SPARTANBURG, SC
ZIP 29303
Phone: (864) 582-6396
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MRS. Kelly Martin Wilson, PA-C is a medical physician assistant in Spartanburg, SC with 17 years of experience. MRS. Kelly Martin Wilson, PA-C NPI is 1396933461. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE
Graduation Year:2007

The provider's business location address is:

1330 BOILING SPRINGS RD
SUITE 1600
SPARTANBURG, SC
ZIP 29303-201
Phone: (864) 582-6396

The NPI 1396933461 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)
  • Aspiration and/or injection of large joint or joint capsule (HCPCS:20610)

The enumeration date for this NPI number is 10/13/2007 and was last updated on 11/9/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363AM0700XPhysician AssistantMedical1237SOUTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10886PAMEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.