Brad Wesley Neville, D.D.S.

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

License

2375 Issued in SC

Practice address

173 Ashley Ave
Room 544 BSB, Division of Oral Pathology, Musc
Charleston, SC 29425-5070

Phone

(843) 792-4495

Fax

(843) 792-3697

NPI assigned

Oct 18, 2006

Last updated

Nov 3, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialty

DentistAlso: Maxillofacial Surgery, Pathology

Education

West Virginia University School of Medicine, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Savannah Multispecialty Associates LLCGroup PAC ID 3678836558, 129 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trident Medical Center Hospital, Charleston, SC, CCN 420079

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Savannah Multispecialty Associates, LLC

  • Trauma Surgery Physician
  • Savannah, GA
  • NPI 1528571320

  SC

  Medicare reassignment Care Compare group NPD
• Medical University of SC

  • Oral and Maxillofacial Pathology Dentistry
  • Charleston, SC
  • NPI 1194026153
  Authorized official Same address or phone

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

• Trident Medical Center, LLC

  dba HCA Healthcare Trident Hospital

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1366496937
  Care Compare affiliation

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320278400000",
    "number": "1275614828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 ASHLEY AVE",
            "address_2": "ROOM 544 BSB, DIVISION OF ORAL PATHOLOGY, MUSC",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294255070",
            "telephone_number": "843-792-4495",
            "fax_number": "843-792-3697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 ASHLEY AVE",
            "address_2": "ROOM 544 BSB, DIVISION OF ORAL PATHOLOGY, MUSC",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294255070",
            "telephone_number": "843-792-4495",
            "fax_number": "843-792-3697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEVILLE",
        "first_name": "BRAD",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2011-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "SC",
            "license": "2375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002375",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bonnie Mechelle Neunsinger, RRT
• Neurology Neurosurgery Clinic, P.a.
• Neurosciences MRI, LLC
• Neurosoul LLC
• Don Dawsey Neuroth Sr., RPH
• Julie H Neville, PA
• New Horizons Therapy, LLC
• New Horizons Therapy, LLC
• New Insights Counseling Services, LLC
• New Land Therapy LLC

• Oral and Maxillofacial Pathology Dentistry in Charleston, SC
• Providers in Charleston, SC by specialty
• Oral and Maxillofacial Pathology Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.