Active NPI
Tavish Brinton, LM, CPM
- Midwife
- Leesville, SC
National Provider Identifier
1114130663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- SCDHEC MW003
- Practice address
- 1644 Charles Town Rd
Leesville, SC 29070-9670 - Phone
- (803) 894-3829
- NPI assigned
- May 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | SCDHEC MW003 | SC | Primary |
Addresses
Primary practice location
1644 Charles Town Rd
Leesville, SC 29070-9670
Mailing address
1644 Charles Town Rd
Leesville, SC 29070-9670
Phone (803) 894-3829
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LM0004 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SCDHEC MW003 | SC | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252368000000",
"number": "1114130663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1644 CHARLES TOWN RD",
"city": "LEESVILLE",
"state": "SC",
"postal_code": "290709670",
"telephone_number": "803-894-3829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1644 CHARLES TOWN RD",
"city": "LEESVILLE",
"state": "SC",
"postal_code": "290709670",
"telephone_number": "803-894-3829"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRINTON",
"first_name": "TAVISH",
"credential": "LM, CPM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-08",
"last_updated": "2009-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "SC",
"license": "SCDHEC MW003",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "LM0004",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Leesville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.