Kenneth Blind, is a medicare enrolled "Physician Assistant - Medical" physician in West Columbia, South Carolina. His current practice location is
2720 Sunset Blvd, West Columbia, South Carolina. You can reach out to his office (for appointments etc.) via phone at
(803) 791-2350.
Kenneth Blind is licensed to practice in South Carolina (license number 4200) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1710590542.
Physician's Profile
| Full Name | Kenneth Blind |
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| Gender | Male |
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| Speciality | Physician Assistant - Medical |
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| Location | 2720 Sunset Blvd, West Columbia, South Carolina |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1710590542
- Provider Enumeration Date: 08/31/2020
- Last Update Date: 04/20/2023
Medicare PECOS Information:
- PECOS PAC ID: 8820488182
- Enrollment ID: I20211201001872
Medical Identifiers
Medical identifiers for Kenneth Blind such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1710590542 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207P00000X | Emergency Medicine | 4200 (South Carolina) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 363AM0700X | Physician Assistant - Medical | 4200 (South Carolina) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kenneth Blind is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kenneth Blind,
300 East Hospital Road,
Fort Gordon, GA 30905
Ph: () - | Kenneth Blind,
2720 Sunset Blvd,
West Columbia, SC 29169-4810
Ph: (803) 791-2350 |
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