Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dustin Thomas Keenan, PA-S

Individual provider Physician Assistant · NPI 1124683420

Dustin Thomas Keenan, PA-S is a Physician Assistant in Columbia, South Carolina. Qualified in 2019, 7 years ago. Practices with Prisma Health Medical Group-Midlands, a 1,018-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in South Carolina.

Years since qualifying
7
Licensed in
SC
In the registry since
2019
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Practice location Address checks out

14 Richland Medical Park Dr Ste 200
Columbia, SC 29203-6882
Phone: (803) 296-7846
Fax: (803) 296-9699
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 300 East Hosptial Road, Fort Gordon, GA 30905 — (864) 491-8450

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 3510 (SC)

Record details

NPI number1124683420
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-S
Sole proprietorNo
NPI enumeratedMay 2, 2019
Last updated in NPPESFebruary 26, 2026
Certification dateFebruary 26, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Prisma Health Medical Group-Midlands — 1018 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Columbia