Individual provider Active NPI

Jeffrey W Buncher, MD

  • Family Medicine Physician
  • Charleston, SC
National Provider Identifier
1255457693
Registry record updated Jul 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
15523 Issued in SC
Practice address
1124 Sam Rittenberg Blvd
Ste 1
Charleston, SC 29407-3362
Phone
(843) 556-3462
Fax
(843) 766-2103
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 15523 SC Primary

Addresses

Primary practice location

1124 Sam Rittenberg Blvd
Ste 1
Charleston, SC 29407-3362

Mailing address

1124 Sam Rittenberg Blvd
Ste 1
Charleston, SC 29407-3362
Phone (843) 556-3462

Other identifiers 2

IdentifierTypeStateIssuer
GP1103MedicaidSC
TL6124MedicaidSC

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100712000316 SC Practitioner - Family PracticePractitioner - Pain ManagementPractitioner - Addiction Medicine 4385796499 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Addiction Medicine, Pain Management
Education
Medical University of South Carolina College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
W M Woodward MD PAGroup PAC ID 6507922093, 2 clinicians

Practice addresses (Care Compare)

1124 Sam Rittenberg Blvd
Suite 1
Charleston, SC 29407-3362
Phone (843) 556-3462

Hospital & facility affiliations

National Provider Directory

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIGDBA/Endpoint/DIGDBA

Organizations & group practices 1

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279584000000",
    "number": "1255457693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 SAM RITTENBERG BLVD",
            "address_2": "STE 1",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294073362",
            "telephone_number": "843-556-3462",
            "fax_number": "843-766-2103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 SAM RITTENBERG BLVD",
            "address_2": "STE 1",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294073362",
            "telephone_number": "843-556-3462",
            "fax_number": "843-766-2103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNCHER",
        "first_name": "JEFFREY",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2010-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "15523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP1103",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TL6124",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.