Active NPI
Brandon Roger Sick, M.D.
- Family Medicine Physician
- Rock Hill, SC
National Provider Identifier
1295752111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 17450
- Practice address
- 2633 Celanese Rd
Rock Hill, SC 29732-1205 - Phone
- (803) 329-5131
- Fax
- (803) 366-6600
- NPI assigned
- Jul 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 17450 | SC | Primary |
| Family Medicine Physician | 207Q00000X | 2006-00021 | NC |
Addresses
Primary practice location
2633 Celanese Rd
Rock Hill, SC 29732-1205
Mailing address
P O Box 602120
Rock Hill, SC 28260-2120
Phone (803) 329-5131
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| T13660 | Medicaid | SC | |
| 13955 | Other | NC | BLUE CROSS BLUE SHIELD |
| P00243983 | Other | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2017 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shiland Family Medicine | Family Medicine | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Charlotte, NC
- NPI 1124357124
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372032000000",
"number": "1295752111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P O BOX 602120",
"city": "ROCK HILL",
"state": "SC",
"postal_code": "282602120",
"telephone_number": "803-329-5131",
"fax_number": "803-366-6600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2633 CELANESE RD",
"city": "ROCK HILL",
"state": "SC",
"postal_code": "297321205",
"telephone_number": "803-329-5131",
"fax_number": "803-366-6600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SICK",
"first_name": "BRANDON",
"middle_name": "ROGER",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-16",
"last_updated": "2013-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SC",
"license": "17450",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "2006-00021",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "T13660",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "13955",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00243983",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rock Hill, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.