Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kacy Clinkenbeard

Individual provider Physician Assistant · NPI 1417579269

Kacy Clinkenbeard is a Physician Assistant in Charleston, South Carolina. Qualified in 2020, 6 years ago. Practices with Baptist Health Medical Group Inc, a 2,445-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Kentucky and South Carolina.

Years since qualifying
6
Licensed in
KY, SC
In the registry since
2020
Specialties on file
4
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Practice location Address checks out

171 Ashley Ave
Charleston, SC 29425-8908
Phone: (843) 792-2300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 4063 (SC)
Physician Assistant Taxonomy 363A00000X · Licence TC962 (KY)
Medical Physician Assistant Taxonomy 363AM0700X · Licence TC962 (KY)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence TC962 (KY)

Record details

NPI number1417579269
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 15, 2020
Last updated in NPPESOctober 6, 2021
Certification dateOctober 6, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Baptist Health Medical Group Inc — 2445 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Charleston