DR. C.W. KELLY PARKE M.D. NPI 1619958485

NPI Information

  • NPI: 1619958485
  • Provider Name: DR. C.W. KELLY PARKE, M.D.
  • Classification: Specialist - 174400000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 129 FLEETWOOD DR
    EASLEY, SC
    ZIP 29640
  • Phone: (864) 855-4255

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NPI Details

DR. C.w. Kelly Parke, M.D. is a specialist in Easley, SC. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. C.w. Kelly Parke, M.D. NPI is 1619958485. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

129 FLEETWOOD DR
EASLEY, SC
ZIP 29640-019
Phone: (864) 855-4255
Fax: (864) 855-4439

The NPI 1619958485 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 11/9/2005 and was last updated on 12/31/2007.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist28367SOUTH 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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1283678MEDICAIDSOUTH CAROLINA
26992MEDICARE PINSOUTH CAROLINA
3D86187MEDICARE UPINSOUTH 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: 3/30/2025

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