Individual provider Active NPI

Brystol Cagle, M.D.

  • Anesthesiology Physician
  • Charleston, SC
National Provider Identifier
1356652036
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
32779 Issued in SC
Practice address
125 Doughty St Ste 420
Charleston, SC 29403-5741
Phone
(843) 723-3441
Fax
(843) 805-4040
NPI assigned
Jun 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 32779 SC Primary

Addresses

Primary practice location

125 Doughty St Ste 420
Charleston, SC 29403-5741

Mailing address

125 Doughty St
Ste 420
Charleston, SC 29403-5741
Phone (843) 723-3441

Other practice location 1

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone (843) 402-1436

Other names 1

  • Brystol Henderson Former name

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
I20141104000332 SC Practitioner - Anesthesiology 8426270653 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of South Carolina School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Associates of Charleston PAGroup PAC ID 4082607361, 38 clinicians

Practice addresses (Care Compare)

1064 Gardner Rd
Suite 112
Charleston, SC 29407-5768
Phone 8437233441551

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone (843) 402-1436

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32779SCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours St Francis Xavier Hospital, Inc. Current Accepting new patients
Anesthesia Associates of Charleston, P.a. Anesthesiology CurrentSince Jul 13, 2015 Accepting new patients
Bon Secours St. Francis Xavier Hospital, Inc. Anesthesiology CurrentSince Aug 18, 2020 Accepting new patients
Anesthesia Associates of Charleston, P.a. CurrentSince Jun 21, 2020 Accepting new patients

Locations

2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037

1064 Gardner Rd
Ste 112
Charleston, SC 29407
Phone (843) 723-3441

125 Doughty St
Ste 420
Charleston, SC 29403
Phone (843) 723-3441

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1356652036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 DOUGHTY ST",
            "address_2": "STE 420",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294035741",
            "telephone_number": "843-723-3441",
            "fax_number": "843-805-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 DOUGHTY ST STE 420",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294035741",
            "telephone_number": "843-723-3441",
            "fax_number": "843-805-4040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2095 Henry Tecklenburg Dr",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294145733",
            "country_code": "US",
            "telephone_number": "843-402-1436",
            "fax_number": "843-402-1833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAGLE",
        "first_name": "BRYSTOL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-28",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SC",
            "license": "32779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRYSTOL",
            "last_name": "HENDERSON",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.