DR. KENNETH CARL STAPLES JR. D.O.
NPI 1265824809
Emergency Medicine in Mullins, SC
About Dr. Kenneth Carl Staples Jr. D.o. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. KENNETH CARL STAPLES JR. D.O. (NPI 1265824809) is an individual emergency medicine provider in Mullins, South Carolina, licensed in South Carolina (82113) and active in the NPI registry since February 2015. He is enrolled in Medicare PECOS and maintains a secondary practice location in Columbus.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Kenneth Carl Staples Jr. D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
3Medicare enrollment records show Kenneth Staples reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Florence, SC 29505
- Reassigned Medicare billing, South Carolina enrollment
- 509 clinicians in this Medicare group
Hartsville, SC 29550
- Reassigned Medicare billing, South Carolina enrollment
- 160 clinicians in this Medicare group
Bamberg, SC 29003
- Reassigned Medicare billing, South Carolina enrollment
- 2,389 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 3
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 29574 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MULLINS, SC 29574
MULLINS, SC 29574
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 Kenneth Staples's NPI number?
The NPI number for Kenneth Staples is 1265824809. It was assigned to this individual provider in the NPPES registry on February 18, 2015.
Where is Kenneth Staples located?
Kenneth Staples practices at 2829 E Highway 76, Mullins, SC 29574. The listed phone number is (843) 431-2000.
What is Kenneth Staples's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Kenneth Staples enrolled in Medicare?
Yes. Kenneth Staples is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Kenneth Staples's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kenneth Staples reassigns Medicare benefits to 3 organizations: Carolina Family Care, Inc (Florence, SC), App Of South Carolina Ed PLLC (Hartsville, SC) and Musc Community Physicians (Bamberg, SC). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kenneth Staples's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kenneth Staples accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina and Molina Healthcare list Kenneth Staples as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Kenneth Staples was last updated on January 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.
# Dr. Kenneth Carl Staples Jr., D.O. · NPI 1265824809
Emergency Medicine physician in Mullins, South Carolina. Individual provider, active in the CMS NPPES registry since February 18, 2015.
## Identity
- **NPI:** 1265824809 (Entity type: Individual)
- **Enumerated:** February 18, 2015
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** 82113 (South Carolina)
- **Sole proprietor:** No
## Practice location
- **Address:** 2829 E HIGHWAY 76, Mullins, SC 29574-6035
- **Phone:** (843) 431-2000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Carolina Family Care, Inc (NPI 1093076457, Florence, SC); App Of South Carolina Ed PLLC (NPI 1457878084, Hartsville, SC); Musc Community Physicians (NPI 1841878006, Bamberg, SC) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 26, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1265824809) · Data from the CMS NPPES public registry.