NPIMap

Individual provider Active NPI

Robert Glen Quattlebaum, M.D.

  • Family Medicine Physician
  • Clemson, SC
National Provider Identifier
1083704175
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
27937 Issued in SC
Practice address
885 Tiger Blvd
Clemson, SC 29631-1480
Phone
(864) 512-7257
Fax
(864) 654-3261
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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 27937 SC Primary

Addresses

Primary practice location

885 Tiger Blvd
Clemson, SC 29631-1480

Mailing address

PO Box 100174
Columbia, SC 29202-3174
Phone (864) 512-7257

Other identifiers 2

IdentifierTypeStateIssuer
P00638301OtherSCRAILROAD MEDICARE ID
279371MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080908000343 SC Practitioner - Family Practice 3577639095 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Carolina at Chapel Hill School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anmed HealthGroup PAC ID 1951215243, 348 clinicians

Practice addresses (Care Compare)

885 Tiger Blvd
Clemson, SC 29631-1480
Phone (864) 654-6800

Hospital & facility affiliations

  • Interim Healthcare of the Upstate Home health agency, Greenville, SC, CCN 427015
  • Anmed Health Hospital, Anderson, SC, CCN 420027
  • Prisma Health Oconee Memorial Hospital Hospital, Seneca, SC, CCN 420009
  • Prisma Health Patewood Hospital Hospital, Greenville, SC, CCN 420102
  • Cannon Memorial Hospital Hospital, Pickens, SC, CCN 420011

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Hospital Inc. CurrentSince Aug 1, 2008 Accepting new patients
Anmed Health Family Medicine Current Accepting new patients
Anmed Health Family Medicine CurrentSince Dec 1, 2009 Accepting new patients
Roper Hospital, Inc. Current Accepting new patients
Anmed Health Family Medicine CurrentSince Dec 1, 2009 Accepting new patients
Roper Hospital, Inc CurrentSince Aug 1, 2008 Accepting new patients
Anmed Health Past Accepting new patients
Anmed Health OB-GYN Associates Past Accepting new patients

Locations

800 N Fant St
Ste A
Anderson, SC 29621
Phone (864) 225-5131

386 College Ave
Clemson, SC 29631
Phone (864) 654-2067

895 Tiger Blvd
Clemson, SC 29631
Phone (864) 512-4530

885 Tiger Blvd
Clemson, SC 29631
Phone (864) 512-4530

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

416 Robertson Blvd
Ste B
Walterboro, SC 29488
Phone (843) 549-2411

Interoperability endpoints

  • Direct secure messaging: rquattlebaum8048@direct.anmedhealth.net

Organizations & group practices 8

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 11

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1083704175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100174",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292023174",
            "telephone_number": "864-512-7257",
            "fax_number": "864-654-3261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 TIGER BLVD",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296311480",
            "telephone_number": "864-512-7257",
            "fax_number": "864-654-3261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUATTLEBAUM",
        "first_name": "ROBERT",
        "middle_name": "GLEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "27937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE ID",
            "identifier": "P00638301",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279371",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clemson, SC

Sources for this page

Verify at the official NPI Registry.