Individual provider Active NPI

Brandy Diane Macdonald, NP-C

  • Family Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1063897585
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19647 Issued in SC
Practice address
2 Roper Corners Cir
Greenville, SC 29615-4833
Phone
(864) 234-7815
Fax
(864) 234-7846
NPI assigned
Jul 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 19647 SC Primary

Addresses

Primary practice location

2 Roper Corners Cir
Greenville, SC 29615-4833

Mailing address

200 N Highway 25
Travelers Rest, SC 29690-2300
Phone (864) 834-7269

Other practice location 1

200 N Highway 25
Travelers Rest, SC 29690-2300
Phone (864) 834-7269

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151110003123 SC Practitioner - Nurse Practitioner 1355651910 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foothills ENT IncGroup PAC ID 4385958370, 7 clinicians

Practice addresses (Care Compare)

2 Roper Corners Cir
Greenville, SC 29615-4833
Phone (864) 234-7815

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince May 21, 2022 Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince May 21, 2022 Accepting new patients
Foothills ENT, Inc CurrentSince Jan 6, 2022 Accepting new patients
St Francis Physician Services Inc Past Accepting new patients

Locations

317 Saint Francis Dr
Ste 220
Greenville, SC 29601
Phone (864) 255-1901

2 Roper Corners Cir
Greenville, SC 29615
Phone (864) 234-7815

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1437868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1063897585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N HIGHWAY 25",
            "city": "TRAVELERS REST",
            "state": "SC",
            "postal_code": "296902300",
            "telephone_number": "864-834-7269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 ROPER CORNERS CIR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154833",
            "telephone_number": "864-234-7815",
            "fax_number": "864-234-7846"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 N Highway 25",
            "address_purpose": "LOCATION",
            "city": "Travelers Rest",
            "state": "SC",
            "postal_code": "296902300",
            "country_code": "US",
            "telephone_number": "864-834-7269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "BRANDY",
        "middle_name": "DIANE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-26",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "19647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.