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

Q: 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.

Q: What is Keith Superdock's specialty?

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

Q: 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.

Active since October 11, 2005PECOS Enrolled

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: September 13, 2026.

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

On this page

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 is enrolled in Medicare PECOS and 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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Keith Robert Superdock Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29605 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$124.04 typical visit price

range $53.57 – $163.84

Typical copayment $31.01 (range $13.39 – $40.96)

Most-billed visit code 99204

Established Patient

$95.12 typical visit price

range $16.96 – $133.52

Typical copayment $23.78 (range $4.24 – $33.38)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tacrolimus, immediate release, oral, 1 mg J7507

Treatment-Treatment - Miscellaneous · category RX029N

4 suppliers44 claims11,160 services$0.32 avg. paid by Medicare

Prednisolone oral, per 5 mg J7510

Treatment-Treatment - Miscellaneous · category RX029N

1 supplier17 claims1,317 services$0.19 avg. paid by Medicare

Mycophenolate mofetil, oral, 250 mg J7517

Treatment-Treatment - Miscellaneous · category RX029N

4 suppliers54 claims12,532 services$0.19 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511

Treatment-Chemotherapy · category RH012N

7 suppliers28 claims28 services$18.34 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512

Treatment-Chemotherapy · category RH012N

7 suppliers66 claims107 services$12.49 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

Is Keith Superdock enrolled in Medicare?

Yes. Keith Superdock is registered in the Medicare PECOS enrollment system.

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.