Brandie Lee Brogdon, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

P-70040 Issued in SC

Practice address

206 Airport CT
Mullins, SC 29574-6196

Phone

(843) 423-8295

NPI assigned

Dec 18, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1639785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639785600000",
    "number": "1104586189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "837 E SELLERS RD",
            "city": "MARION",
            "state": "SC",
            "postal_code": "295716417",
            "telephone_number": "843-610-6849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 AIRPORT CT",
            "city": "MULLINS",
            "state": "SC",
            "postal_code": "295746196",
            "telephone_number": "843-423-8295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROGDON",
        "first_name": "BRANDIE",
        "middle_name": "LEE",
        "name_prefix": "Miss",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-18",
        "last_updated": "2021-12-18",
        "certification_date": "2021-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "SC",
            "license": "P-70040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Todd S Blevins, DMD
• Bomac Inc
• Bones III Medical, LLC
• William D Brock
• Christopher Brockington, BS, MS, MSPC
• William Brown Jr., PHARM.D.
• Maticia Brunson
• Campbell Family Practice
• Campbell Family Practice, P.a.
• Campbell Medical Supply

• All providers in Mullins, SC
• Licensed Practical Nurse in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.