NPIMap

Individual provider Active NPI

Brian D. Forbus, PA-C

  • Medical Physician Assistant
  • Conway, SC
National Provider Identifier
1225103302
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
A773 Issued in SC
Practice address
2767 Cultra Rd
Conway, SC 29526-3716
Phone
(843) 438-8470
NPI assigned
Nov 22, 2006
Last updated
May 26, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X A773 SC Primary

Addresses

Primary practice location

2767 Cultra Rd
Conway, SC 29526-3716

Mailing address

2767 Cultra Rd
Conway, SC 29526-3716
Phone (843) 438-8470

Other identifiers 1

IdentifierTypeStateIssuer
0060PAMedicaidSC

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
I20090414000709 SC Practitioner - Physician Assistant 8527115252 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlantic Coast Pain Specialists IncGroup PAC ID 6507179348, 2 clinicians

Practice addresses (Care Compare)

2767 Cultra Rd
Conway, SC 29526-3716
Phone (843) 438-8470

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
A773SCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medicos, P.a. PastSince Feb 11, 2024 Accepting new patients
LB & KM LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1225103302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2767 CULTRA RD",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295263716",
            "telephone_number": "843-438-8470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2767 CULTRA RD",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295263716",
            "telephone_number": "843-438-8470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORBUS",
        "first_name": "BRIAN",
        "middle_name": "D.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "A773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0060PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, SC

Sources for this page

Verify at the official NPI Registry.