Individual provider Active NPI

Brendon Garrity

  • Emergency Medicine Physician
  • Greenville, SC
National Provider Identifier
1083319032
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
LL90002 Issued in SC
Practice address
701 Grove Rd
Greenville, SC 29605-4210
Phone
(864) 455-5198
NPI assigned
Mar 31, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X LL90002 SC Primary

Addresses

Primary practice location

701 Grove Rd
Greenville, SC 29605-4210

Mailing address

701 Grove Rd
Greenville, SC 29605-4210

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
I20230908002259 SC Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 8820452816

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1643 NW 136 Ave
Sunrise, FL 33323-2857

1643 NW 136TH Ave
Sunrise, FL 33323-2857

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LL90002SCMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1680220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1083319032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 GROVE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 GROVE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054210",
            "telephone_number": "864-455-5198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRITY",
        "first_name": "BRENDON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-31",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "LL90002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.