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

Kelly Blake Cantu, PA-C

Individual provider Pain Medicine (Physical Medicine & Rehabilitation) Physician · NPI 1174718738

Kelly Blake Cantu, PA-C is a Physician Assistant in Columbia, South Carolina. Qualified in 2007, 19 years ago. Practices with Active Life Health of Columbia LLC, a 6-clinician group and accepts Medicare assignment. Licensed in South Carolina.

Years since qualifying
19
Licensed in
SC
In the registry since
2007
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

2000 Center Point Rd Ste 2360
Columbia, SC 29210-5826
Phone: (803) 233-5500
Fax: (803) 258-6395
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pain Medicine (Physical Medicine & Rehabilitation) Physician (primary) Taxonomy 2081P2900X · Licence 1770252017 (SC)

Record details

NPI number1174718738
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 7, 2007
Last updated in NPPESOctober 22, 2024
Certification dateOctober 22, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Active Life Health Of Columbia Llc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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