Individual provider Active NPI

Brandon Kyle Glover, PHARMD

  • Pharmacist
  • Charleston, SC
National Provider Identifier
1376892653
Registry record updated Sep 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
10338 Issued in SC
Practice address
1739 Maybank Hwy
Charleston, SC 29412-2103
Phone
(843) 795-0792
NPI assigned
Sep 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 10338 SC Primary

Addresses

Primary practice location

1739 Maybank Hwy
Charleston, SC 29412-2103

Mailing address

109 E Bay St Apt 1D
Charleston, SC 29401-2549
Phone (843) 722-9475

Other names 1

  • Dr. Brandon Kyle Robottom Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
10338SCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1346544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346544000000",
    "number": "1376892653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 E BAY ST APT 1D",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294012549",
            "telephone_number": "843-722-9475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1739 MAYBANK HWY",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294122103",
            "telephone_number": "843-795-0792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "BRANDON",
        "middle_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-02",
        "last_updated": "2012-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "10338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDON",
            "last_name": "ROBOTTOM",
            "middle_name": "KYLE",
            "prefix": "DR.",
            "credential": "PHARMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.