Charles L. Gaillard, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

22444 Issued in SC

Practice address

526 North St
Bamberg, SC 29003-1319

Phone

(803) 245-2433

Fax

(803) 245-7424

NPI assigned

Oct 31, 2007

Last updated

Jun 3, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cgaillard@bfp.ssdirect.aprima.com

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.

• F. Marion Dwight, MD,PA

  dba Bamberg Family Practice

  • Family Medicine Physician
  • Bamberg, SC
  • NPI 1366407231
  Medicare reassignment NPD
• Gaillard & Hinnant Family Practice LLC

  • Family Medicine Physician
  • Anderson, SC
  • NPI 1871556357
  NPD (past) Authorized official
• Anderson Wellness Center

  • Chiropractor
  • Anderson, SC
  • NPI 1528113362
  NPD (past)
• F Marion Dwight MD PA

  • Rural Health Clinic/Center
  • Bamberg, SC
  • NPI 1639212228
  NPD (past)

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307059200000",
    "number": "1437338068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 524",
            "city": "BAMBERG",
            "state": "SC",
            "postal_code": "290030524",
            "telephone_number": "803-245-2433",
            "fax_number": "803-245-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 NORTH ST",
            "city": "BAMBERG",
            "state": "SC",
            "postal_code": "290031319",
            "telephone_number": "803-245-2433",
            "fax_number": "803-245-7424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAILLARD",
        "first_name": "CHARLES",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-31",
        "last_updated": "2011-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "22444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE UNSPECIFIED",
            "identifier": "423828",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHC151",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHC020",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE UNSPECIFIED",
            "identifier": "428926",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cameron Lee Eubanks, PHARM.D.
• F Marion Dwight MD PA
• F. M. Dwight, MD, PA
• F. Marion Dwight, MD,PA (Bamberg Family Practice)
• Five Feathers Management Group, LLC (Bamberg Medical Group)
• Eva Gaillard, RN
• Sheryl Edgemon Gardner, RNC
• Richard Bernard Gunter, RPH
• Angela Hampton, PA-C
• Roger Shawn Heatley

• Family Medicine Physician in Bamberg, SC
• Providers in Bamberg, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.