Individual provider Active NPI

James Bertrand O'Bryan, MD

  • Hematology & Oncology Physician
  • Charleston, SC
National Provider Identifier
1023696176
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
LL92220 Issued in SC
Practice address
171 Ashley Ave
Charleston, SC 29425-2113
Phone
(843) 792-1414
NPI assigned
Mar 31, 2021
Last updated
Jun 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X LL92220 SC Primary

Addresses

Primary practice location

171 Ashley Ave
Charleston, SC 29425-2113

Mailing address

3800 Reservoir Rd NW
Washington, DC 20007-2113
Phone (202) 444-8168

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250324003472 SC Practitioner - Internal Medicine 0749703338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Virginia Commonwealth University, School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
24 On Physicians of SC LLCGroup PAC ID 5890127344, 136 clinicians

Practice addresses (Care Compare)

316 Calhoun St
Charleston, SC 29401-1113
Phone (843) 724-2901

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
LL92220SCMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
24 On Physicians of SC, LLC CurrentSince Apr 1, 2025 Accepting new patients

Locations

13000 Deerfield Pkwy
Ste 100
Alpharetta, GA 30004

2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1023696176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 RESERVOIR RD NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200072113",
            "telephone_number": "202-444-8168",
            "fax_number": "877-303-1460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294252113",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRYAN",
        "first_name": "JAMES",
        "middle_name": "BERTRAND",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-31",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "SC",
            "license": "LL92220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.