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KEITH ROBERT SUPERDOCK MD
NPI 1700874021
Internal Medicine - Nephrology in Greenville, SC

Active since October 11, 2005
701 GROVE RD, GREENVILLE, SC 29605(864) 455-5648(864) 455-7862 Get Directions Write a Review

NPPES record last updated: July 21, 2021. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Jul 21, 2021, Oct 6, 2020, Oct 4, 2020 and 1 more (4 updates tracked since 2016).

About Keith Robert Superdock Md NPPES

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

KEITH ROBERT SUPERDOCK MD (NPI 1700874021) is an individual nephrology provider in Greenville, South Carolina, licensed in South Carolina (85922) and active in the NPI registry since October 2005. He maintains a secondary practice location in Wynnewood.

NPPES Registry Identity

NPI1700874021
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameKEITH ROBERT SUPERDOCKCredential: MD
Location Address701 GROVE RDGreenville, SC 29605-4210
Mailing Address300 E Mcbee Ave Fl 4Greenville, SC 29601-2842 · (864) 522-8603
Phone(864) 455-5648
Fax(864) 455-7862
Sole ProprietorNo
Enumeration DateOctober 11, 2005
Last NPPES UpdateJuly 21, 20214 updates tracked since enumeration
NPPES CertifiedJuly 21, 2021
✔ NPI 1700874021 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Licenses✔ Licensed in SC · 85922✔ Licensed in PA · MD049781L
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
701 GROVE RD, Greenville, SC 29605
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Secondary Practice Location 1

Location 1100 E Lancaster Ave Ste 130Wynnewood, PA 19096-3453 · Phone (610) 649-1175 · Fax (610) 896-8753

Other Identifiers 2

MedicaidPENDINGSC
Medicaid0014136400001PA

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.

DANIEL RUIZ
Internal Medicine
701 GROVE RD
GREENVILLE, SC 29605
Greenville County (864) 455-7882
ALAN ROBERT THOMPSON MD
Hospitalist
701 GROVE RD, 5TH FLOOR
GREENVILLE, SC 29605
Greenville County (864) 455-4411
GEORGE R SWEET CRNA
Nurse Anesthetist, Certified Registered
701 GROVE RD, ANESTHESIA DEPT
GREENVILLE, SC 29605
Greenville County (864) 455-7111
CRAIG DOUGLAS YOUNG PHD
Clinical Neuropsychologist
701 GROVE RD
GREENVILLE, SC 29605
Greenville County (864) 455-7000
JENNIFER WEBB GEORGE CRNA
Nurse Anesthetist, Certified Registered
701 GROVE RD
GREENVILLE, SC 29605
Greenville County (864) 455-7111
MEENU MARIE VARGHESE D.O.
Internal Medicine
701 GROVE RD, 5TH FLOOR SUPPORT TOWER
GREENVILLE, SC 29605
Greenville County (864) 455-7882
AMANDA TIPTON LARSON CRNA
Nurse Anesthetist, Certified Registered
701 GROVE RD
GREENVILLE, SC 29605
Greenville County (864) 522-2286
TYLER WITHROW
Nurse Anesthetist, Certified Registered
701 GROVE RD
GREENVILLE, SC 29605
Greenville County (864) 455-7000

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 Keith Superdock's NPI number?

The NPI number for Keith Superdock is 1700874021. It was assigned to this individual provider in the NPPES registry on October 11, 2005.

Where is Keith Superdock located?

Keith Superdock practices at 701 Grove Rd, Greenville, SC 29605. The listed phone number is (864) 455-5648.

What is Keith Superdock's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

When was this NPI record last updated?

The NPPES record for Keith Superdock was last updated on July 21, 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.