Individual provider Active NPI

Bryan D Tompkins, DO

  • Family Medicine Physician
  • Walterboro, SC
National Provider Identifier
1053468322
Registry record updated Jan 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36429 Issued in SC
Practice address
107 Church St
Walterboro, SC 29488-2901
Phone
(843) 549-1558
Fax
(843) 549-1454
NPI assigned
Jan 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36429 SC Primary

Addresses

Primary practice location

107 Church St
Walterboro, SC 29488-2901

Mailing address

107 Church St
Walterboro, SC 29488-2901
Phone (843) 549-1558

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
I20140423000650 SC Practitioner - Family Practice 0042442238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oklahoma State University College of Osteopathic Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Walterboro Family Practice Associates PAGroup PAC ID 5698667855, 6 clinicians

Practice addresses (Care Compare)

107 Church St
Walterboro, SC 29488-2901
Phone (843) 549-1558

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36429SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Walterboro Family Practice Associates, P.a. Family Medicine CurrentSince Feb 28, 2014 Accepting new patients

Locations

107 Church St
Walterboro, SC 29488
Phone (803) 549-1558

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IAECBD/Endpoint/IAECBD

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Walterboro Family Practice Associates PAWalterboro, SC, CCN 428915 Rural health clinic 5% Or Greater Direct Ownership Interest (20%) Jan 1, 2015

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516579200000",
    "number": "1053468322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 CHURCH ST",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294882901",
            "telephone_number": "843-549-1558",
            "fax_number": "843-549-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 CHURCH ST",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294882901",
            "telephone_number": "843-549-1558",
            "fax_number": "843-549-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMPKINS",
        "first_name": "BRYAN",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2018-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "36429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walterboro, SC

Sources for this page

Verify at the official NPI Registry.