Individual provider Active NPI

Bryan William Brooks, MD

  • Obstetrics & Gynecology Physician
  • Greenville, SC
National Provider Identifier
1184006348
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
38535 Issued in SC
Practice address
890 W Faris Rd Ste 470
Greenville, SC 29605-4281
Phone
(864) 455-1600
Fax
(864) 455-3095
NPI assigned
Jun 24, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD-48852 IA
Obstetrics & Gynecology Physician 207V00000X 38535 SC Primary

Addresses

Primary practice location

890 W Faris Rd Ste 470
Greenville, SC 29605-4281

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 695-6697

Other practice location 1

525 Verdae Blvd Ste 150
Greenville, SC 29607-4021
Phone (864) 720-1900

Other practice location 2

102 Medical Park Court
Clinton, SC 29325-4021
Phone (864) 938-0087

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190822002544 SC Practitioner - Obstetrics/Gynecology 6406164284 Reassigns benefits to 1 organization
I20210908000822 IA Practitioner - Obstetrics/GynecologyPractitioner - Psychiatry 6406164284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of South Carolina School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

890 W Faris Rd
Suite 470
Greenville, SC 29605-4281
Phone (864) 455-1600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-48852IAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System Obstetrics & Gynecology CurrentSince Sep 7, 2021 Accepting new patients
Community Health Care, Inc. Current Accepting new patients
Community Health Care Inc CurrentSince Dec 1, 2021 Accepting new patients
Community Health Care, Inc. CurrentSince Dec 1, 2021 Accepting new patients
Genesis Health System CurrentSince Sep 7, 2021 Accepting new patients
Musc Affiliate Physicians Obstetrics & Gynecology PastSince May 25, 2021 Accepting new patients
Prisma Health-Upstate Past Accepting new patients
Genesis Health System Past Accepting new patients

Locations

865 Lincoln Rd
Ste 100
Bettendorf, IA 52722
Phone (563) 355-1000

210 W 53rd St
Davenport, IA 52806
Phone (563) 386-3436

500 W River Dr
Davenport, IA 52801
Phone (563) 327-2035

1227 E Rusholme St
Davenport, IA 52803
Phone (563) 324-8160

1510 E Rusholme St
Davenport, IA 52803
Phone (563) 359-6633

619 5th St
Durant, IA 52747
Phone (563) 785-4487

Interoperability endpoints

  • Direct secure messaging: bbrooks19781@direct.ghs.myhfn.org

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1184006348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-695-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 W FARIS RD STE 470",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054281",
            "telephone_number": "864-455-1600",
            "fax_number": "864-455-3095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 Verdae Blvd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296074021",
            "country_code": "US",
            "telephone_number": "864-720-1900",
            "fax_number": "864-720-1901",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "102 Medical Park Court",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "SC",
            "postal_code": "293254021",
            "country_code": "US",
            "telephone_number": "864-938-0087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "BRYAN",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-24",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IA",
            "license": "MD-48852",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "38535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.