NPIMap

Individual provider Active NPI

Keith Eric Brightbill II, M.D.

  • Urology Physician
  • West Columbia, SC
National Provider Identifier
1104049980
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
29884 Issued in SC
Practice address
111 W Hospital Dr
West Columbia, SC 29169-3405
Phone
(803) 796-8515
Fax
(803) 796-8516
NPI assigned
Apr 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 29884 SC Primary

Addresses

Primary practice location

111 W Hospital Dr
West Columbia, SC 29169-3405

Mailing address

9735 Kincey Ave
Suite 201
Huntersville, NC 28078-9118
Phone (704) 414-2870

Other identifiers 1

IdentifierTypeStateIssuer
298840MedicaidSC

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
I20071004000419 SC Practitioner - Urology 0941395040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Ohio State University College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Urology Partners PLLCGroup PAC ID 8921280587, 37 clinicians

Practice addresses (Care Compare)

1780 Medical Park Dr
Rock Hill, SC 29732-1194
Phone (803) 327-1116

Hospital & facility affiliations

  • Enhabit Home Health Aiken Home health agency, Columbia, SC, CCN 427128
  • Lexington Medical Center Hospital, West Columbia, SC, CCN 420073
  • Musc Health Columbia Medical Center Downtown Hospital, Columbia, SC, CCN 420026
  • Prisma Health Baptist Parkridge Hospital, Columbia, SC, CCN 420106
  • Musc Medical Center Hospital, Charleston, SC, CCN 420004
  • Prisma Health Richland Hospital Hospital, Columbia, SC, CCN 420018

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection30

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29884SCMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Urology Partners PLLC Urology CurrentSince Oct 1, 2011 Accepting new patients
Carolina Urology Practice Past Accepting new patients

Locations

9735 Kincey Ave
Ste 201
Huntersville, NC 28078
Phone (704) 414-2865

1780 Medical Park Dr
Rock Hill, SC 29732
Phone (803) 327-1116

111 W Hospital Dr
West Columbia, SC 29169
Phone (803) 796-8515

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: keith.brightbill.p1@direct.cup.nextgenshare.com

Organizations & group practices 2

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 20

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1104049980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9735 KINCEY AVE",
            "address_2": "SUITE 201",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280789118",
            "telephone_number": "704-414-2870",
            "fax_number": "704-414-2860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W HOSPITAL DR",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693405",
            "telephone_number": "803-796-8515",
            "fax_number": "803-796-8516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIGHTBILL",
        "first_name": "KEITH",
        "middle_name": "ERIC",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "SC",
            "license": "29884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "298840",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

Verify at the official NPI Registry.