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

Mrs. Kimberly W Reisenauer, PA

Individual provider Physician Assistant · NPI 1023149101

Mrs. Kimberly W Reisenauer, PA is a Physician Assistant in Sumter, South Carolina. Graduated from Medical University of South Carolina College of Medicine in 2000, 26 years ago. Practices with Colonial Family Practice LLC, a 57-clinician group. Licensed in South Carolina.

Years since qualifying
26
Trained at
Medical University of South Carolina College of Medicine
Licensed in
SC
In the registry since
2007
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

325 Broad St Ste 100
Sumter, SC 29150-4167
Phone: (803) 773-5227
Fax: (803) 774-5400
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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 638 (SC)

Record details

NPI number1023149101
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedMarch 8, 2007
Last updated in NPPESFebruary 1, 2012

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolMEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE
Graduated 2000 (26 years in practice)
Group practice Colonial Family Practice Llc — 57 clinicians
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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