Holbrook Wyman Raynal, M.D., D.H.A.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

8942 Issued in SC

Practice address

210 S Broad St
Clinton, SC 29325-2505

Phone

(864) 833-0973

Fax

(864) 833-9571

NPI assigned

Jan 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Prisma Health University Medical Group

  • Family Medicine Physician
  • Greenville, SC
  • NPI 1295763217
  Medicare reassignment NPD
• Preserve Health, PA

  • Family Medicine Physician
  • Travelers Rest, SC
  • NPI 1124299375
  NPD (past) Authorized official
• Prisma Health University Medical Group

  • Gynecology Physician
  • Greer, SC
  • NPI 1003619313
  NPD
• The Family Healthcare Center

  • Family Medicine Physician
  • Clinton, SC
  • NPI 1457399396
  NPD (past)

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378771200000",
    "number": "1124099874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT",
            "address_2": "SUITE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154545",
            "telephone_number": "864-797-6044",
            "fax_number": "864-797-6198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S BROAD ST",
            "city": "CLINTON",
            "state": "SC",
            "postal_code": "293252505",
            "telephone_number": "864-833-0973",
            "fax_number": "864-833-9571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYNAL",
        "first_name": "HOLBROOK",
        "middle_name": "WYMAN",
        "credential": "M.D., D.H.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2013-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "8942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "089424",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Prisma Health-Upstate
• Prohealth Center, LLC
• Heather Puchel
• Kimberly B Pugh, M.D.
• Pankajkumar Ravani
• RCG University Division, Inc.
• Randall Louis Reinhardt, MD
• Don R Revis Sr., R PH
• Reynolds Family Dentistry, PA
• Dawn Sherer Reynolds, DMD

• Family Medicine Physician in Clinton, SC
• Providers in Clinton, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.