KELLY BLAKE CANTU PA-C
NPI 1174718738
Physical Medicine & Rehabilitation - Pain Medicine in Columbia, SC

Q: What is Kelly Cantu's NPI number?

The NPI number for Kelly Cantu is 1174718738. It was assigned to this individual provider in the NPPES registry on September 7, 2007. The provider is also known as Kelly Blake Ryder Pa-C.

Q: What is Kelly Cantu's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation, specializing in Pain Medicine, with taxonomy code 2081P2900X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Cantu was last updated on October 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 07, 2007PECOS EnrolledAccepts Medicare Assignment

2000 CENTER POINT RD STE 2360, COLUMBIA, SC 29210(803) 233-5500(803) 258-6395 Get Directions Write a Review

NPPES record last updated: October 22, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 1, 2020, Nov 17, 2015 (2 updates tracked since 2015).

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About Kelly Blake Cantu Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY BLAKE CANTU PA-C (NPI 1174718738) is an individual pain medicine provider in Columbia, South Carolina, licensed in South Carolina (1770252017) and active in the NPI registry since September 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2007).

NPPES Registry Identity

NPI1174718738

Entity TypeIndividualFemale

Primary Taxonomy2081P2900X

Provider Legal NameKELLY BLAKE CANTUCredential: PA-C

Location Address2000 CENTER POINT RD STE 2360Columbia, SC 29210-5826

Mailing Address2000 Center Point Rd Ste 2360Columbia, SC 29210-5826 · (803) 233-5500 · Fax (803) 258-6395

Phone(803) 233-5500

Fax(803) 258-6395

Sole ProprietorNo

Medical School CMSOtherGraduated 2007

Enumeration DateSeptember 7, 2007

Last NPPES UpdateOctober 22, 20242 updates tracked since enumeration

NPPES CertifiedOctober 22, 2024

✔ NPI 1174718738 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Medicine & Rehabilitation · Pain MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2081P2900X

License✔ Licensed in SC · 1770252017

Definition

A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.

2000 CENTER POINT RD STE 2360, Columbia, SC 29210

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Other Names 1

Former Name (1)Kelly Blake Ryder Pa-c

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly Blake Cantu Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8729148747

PECOS Enrollment IDI20250926003508

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ACTIVE LIFE HEALTH OF COLUMBIA, LLC

Physical Medicine & Rehabilitation

2000 CENTER POINT RD STE 2360
COLUMBIA, SC 29210

Richland County (803) 233-5500

ACTIVE LIFE HEALTH OF COLUMBIA, LLC

Durable Medical Equipment & Medical Supplies

2000 CENTER POINT RD STE 2360
COLUMBIA, SC 29210

Richland County (803) 233-5500

TERESSA MAE OLDSON MD

Family Medicine

2000 CENTER POINT RD STE 2360
COLUMBIA, SC 29210

Richland County (803) 233-5500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Cantu's NPI number?

The NPI number for Kelly Cantu is 1174718738. It was assigned to this individual provider in the NPPES registry on September 7, 2007. The provider is also known as Kelly Blake Ryder Pa-C.

Where is Kelly Cantu located?

Kelly Cantu practices at 2000 Center Point Rd Ste 2360, Columbia, SC 29210. The listed phone number is (803) 233-5500.

What is Kelly Cantu's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation, specializing in Pain Medicine, with taxonomy code 2081P2900X.

Is Kelly Cantu enrolled in Medicare?

Yes. Kelly Cantu is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Kelly Cantu was last updated on October 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.