DR. JOHN EDGAR KLECKLEY (NPI# 1356544100) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356544100 |
| Entity Type | Individual |
| Full Name | DR. JOHN EDGAR KLECKLEY |
| Credential | M.D. |
| Practice Address |
244 Church St Sumter SC 29150-4256 |
| Practice Telephone | 8037751001 |
| Practice Fax Number | 8037741012 |
| Mailing Telephone | 8037751001 |
| Mailing Fax Number | 8037741012 |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2013-06-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
TL29749 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | RAILROAD MEDICARE PIN | P00467100 | 01 |
| SC | RAILROAD MEDICARE ID-RSFPN | P00803393 | 01 |
| SC | 297495 | 05 |
| Street Address |
244 CHURCH ST |
| City | SUMTER |
| State | SC |
| Zip Code | 29150-4256 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497743595 | Hugh T Stoddard Jr. | Internal Medicine | 244 Church St, Sumter, SC 29150-4256 | 2005-10-12 |
| 1063897726 | Laurin Gaymon Lee | Nurse Practitioner | 244 Church St, Sumter, SC 29150-4256 | 2015-07-23 |
| 1760815088 | Tracie Smith | Nurse Practitioner | 244 Church St, Sumter, SC 29150 | 2013-08-11 |
| 1124313101 | Carolina Geriatric Specialists, LLC | Specialist | 244 Church St, Sumter, SC 29150-4256 | 2011-06-17 |
| 1265418164 | Macdonald Mayes Dubose | Family Medicine | 244 Church St, Sumter, SC 29150-4256 | 2005-12-22 |
| 1790773752 | Internal Medical Associates, Pa | Internal Medicine | 244 Church St, Sumter, SC 29150-4256 | 2005-10-12 |
| 1487642443 | Philip H Brandt | Internal Medicine | 244 Church St, Sumter, SC 29150-4256 | 2005-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174152557 | Stacey Delene Mcconico | Adult Companion | 201 East Liberty Street, Sumter, SC 29150 | 2020-04-07 |
| 1780227942 | Add Light Home Care LLC | In Home Supportive Care | 698-s Bultman Dr, Suite C-8, Sumter, SC 29150 | 2019-10-21 |
| 1770044075 | Kimberly A Weeks | Technician, Other | 5 E Liberty Street, Sumter, SC 29150 | 2019-03-28 |
| 1689155103 | Chrishena E Craig | Social Worker | 801 N. Pike West, Sumter, SC 29150 | 2018-08-23 |
| 1093200735 | Michael B Coseo | Dietitian, Registered | 1278 N. Lafayette Drive, Sumter, SC 29150 | 2018-06-26 |
| 1790287258 | Keever Murdaugh | Physical Therapy Assistant | 1018 North Guignard Drive, Sumter, SC 29150 | 2018-03-01 |
| 1679094643 | James D Pearson | Emergency Medical Technician, Basic | 9b Willow Drive, Sumter, SC 29150 | 2017-06-29 |
| 1245771781 | Shanekia Littles | In Home Supportive Care | 251 Rast St Unit D-1, Sumter, SC 29150 | 2017-03-16 |
| 1326590415 | Believe In Faith Home Care | In Home Supportive Care | 410 W Liberty St Suite 102, Sumter, SC 29150 | 2016-10-25 |
| 1912368457 | Urology Clinic, Inc. | Urology | 1285 Wilson Hall Rd, Sumter, SC 29150 | 2016-03-11 |
| Find all providers in zip 29150 | ||||
| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760430573 | Marion Henry Davis Jr. | Family Medicine | 215 N. Magnolia, Sumter, SC 29151-1946 | 2006-05-04 |
| 1265418164 | Macdonald Mayes Dubose | Family Medicine | 244 Church St, Sumter, SC 29150-4256 | 2005-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487031001 | Charleston Geriatrics and Post - Acute Care LLC | Family Medicine | 930 Tall Pine Rd, Mount Pleasant, SC 29464-2910 | 2015-05-04 |
| 1699041160 | Sarah E Whitehead | Family Medicine | Paris View Family Medicine, 1028 North Church Street, Greenville, SC 29601-1639 | 2012-03-28 |
| 1376854406 | Liberty Doctors, LLC | Family Medicine | 8761 Dorchester Rd, Suite 230, North Charleston, SC 29420-7322 | 2010-06-23 |
| 1720310055 | Green Ridge Group Inc | Family Medicine | 100 Forum Dr, Ste 3-255, Columbia, SC 29229-7944 | 2010-02-11 |
| 1306076542 | Veena G Naidu | Family Medicine | 203 Sapphire Vly, Anderson, SC 29621-4285 | 2009-07-22 |
| 1922236751 | Roper Saint Francis Physicians Network | Family Medicine | 4959 Highway 17, Murrells Inlet, SC 29576 | 2009-07-01 |
| 1265696439 | St. Andrews Surgical Assoc. PC | Family Medicine | 1006 Old Chapin Rd, Lexington, SC 29072-9549 | 2008-07-16 |
| 1417146127 | Russell G. Gaddy M.d. | Family Medicine | 10 Winchester Ct, Mauldin, SC 29662-2627 | 2007-10-18 |
| 1982724241 | Mark J. Meiler, Md | Family Medicine | 124 Live Oak Rd, Aiken, SC 29803-2663 | 2007-03-30 |
| 1518090901 | Andres Felix Leone | Family Medicine | 3 Richland Medical Park Dr Ste 510, Columbia, SC 29203-6854 | 2007-03-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.