Active NPI
Timothy Brandt
- Urology Physician
- Greenville, SC
National Provider Identifier
1083207740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 97632
- Practice address
- 48 Centennial Way
Greenville, SC 29605-4662 - Phone
- (864) 522-8000
- Fax
- (864) 522-8005
- NPI assigned
- Feb 14, 2021
- Last updated
- Aug 21, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Urology Physician | 208800000X | 97632 | SC | Primary |
| General Practice Physician | 208D00000X | 35510 | NE |
Addresses
Primary practice location
48 Centennial Way
Greenville, SC 29605-4662
Mailing address
300 E McBee Ave Ste 300
Greenville, SC 29601-2899
Phone (864) 522-8603
Other practice location 1
9040 Jackson Ave
Tacoma, WA 98431-0001
Phone (253) 968-2417
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35510 | NE | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787270400000",
"number": "1083207740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 E MCBEE AVE STE 300",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296012899",
"telephone_number": "864-522-8603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "48 CENTENNIAL WAY",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296054662",
"telephone_number": "864-522-8000",
"fax_number": "864-522-8005"
}
],
"practiceLocations": [
{
"address_1": "9040 Jackson Ave",
"address_purpose": "LOCATION",
"city": "Tacoma",
"state": "WA",
"postal_code": "984310001",
"country_code": "US",
"telephone_number": "253-968-2417",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRANDT",
"first_name": "TIMOTHY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-02-14",
"last_updated": "2026-08-21",
"certification_date": "2026-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "SC",
"license": "97632",
"primary": true
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "NE",
"license": "35510",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.