Individual provider Active NPI

Russell V Brant, MD

  • Internal Medicine Physician
  • Sumter, SC
National Provider Identifier
1508859927
Registry record updated Mar 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9199 Issued in SC
Practice address
1278 N Lafayette Dr
Sumter, SC 29150-2964
Phone
(803) 774-4500
Fax
(803) 974-4627
NPI assigned
Aug 31, 2005
Last updated
Mar 4, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9199 SC Primary

Addresses

Primary practice location

1278 N Lafayette Dr
Sumter, SC 29150-2964

Mailing address

1278 N Lafayette Dr
Sumter, SC 29150-2964
Phone (803) 774-4500

Other identifiers 1

IdentifierTypeStateIssuer
372048MedicaidSC

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
I20101220000909 SC Practitioner - Internal Medicine 3476535469 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Indiana University School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tandem Health SCGroup PAC ID 3870575855, shared by 10 NPIs, 32 clinicians

Practice addresses (Care Compare)

425 N Salem Ave
Sumter, SC 29150-4115
Phone (803) 774-4500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tandem Health SC CurrentSince Mar 1, 2001 Accepting new patients
Tandem Health SC CurrentSince Jul 1, 2024 Accepting new patients
Tandem Health SC CurrentSince Mar 1, 2001 Accepting new patients
Tandem Health SC Past Accepting new patients

Locations

100 W Liberty St
Sumter, SC 29150
Phone (803) 773-0032

1278 N Layfayette St
Sumter, SC 29150

425 N Salem Ave
Sumter, SC 29150
Phone (803) 773-8148

550 S Pike W
Sumter, SC 29150

Interoperability endpoints

  • Direct secure messaging: russell.brant.1@13095.direct.athenahealth.com

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

Hospital & facility affiliations 2

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": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267660800000",
    "number": "1508859927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1278 N LAFAYETTE DR",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291502964",
            "telephone_number": "803-774-4500",
            "fax_number": "803-744-4627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1278 N LAFAYETTE DR",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291502964",
            "telephone_number": "803-774-4500",
            "fax_number": "803-974-4627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANT",
        "first_name": "RUSSELL",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2010-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "9199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "372048",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumter, SC

Sources for this page

Verify at the official NPI Registry.