Charles Bradley Harrison, PA-C
Individual provider Active NPI Surgical Physician Assistant · Spartanburg, SC
NPI 1528079183 · NPPES record last updated Feb 24, 2014
Key facts
- NPI
- 1528079183
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- 1028 (SC)
- Practice address
- 1330 Boiling Springs Rd
Suite 1600
Spartanburg, SC 29303 - Phone
- (864) 582-6396
- Fax
- (864) 582-1608
- NPI assigned
- Aug 10, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Carolina Orthopaedic and Neurosurgical Associates
Practice addresses (Care Compare)
115 Deacon Tiller CT
Duncan, SC 29334-8880
Phone (864) 582-6396
1330 Boiling Springs Rd
Suite 1600
Spartanburg, SC 29303-4219
Phone (864) 582-6396
Hospital & facility affiliations
- Spartanburg Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 79.05 of 100
- Quality
- 68.98
- Promoting interoperability
- 93
- Improvement activities
- 40
- Cost
- 67.04
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050706000879 | SC | Practitioner - Physician Assistant | 6608812185 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1028 | SC | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolina Orthopaedic and Neurosurgical Associates | Current |
Accepting new patients | |
| Carolina Orthopaedic and Neurosurgical Associates | Surgical | Current |
Accepting new patients |
| Tennessee Orthopaedic Alliance PA | Past | Accepting new patients | |
| Tennessee Orthopaedic Alliance PA | Past | Accepting new patients |
Locations
115 Deacon Tiller Ct
Duncan, SC 29334
Phone (864) 582-6396
1330 Boiling Springs Rd
Ste 1600
Spartanburg, SC 29303
Phone (864) 582-6396
Interoperability endpoints
- charles.harrison.pac.1@26879.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 1028 | SC | Yes |
Addresses
Primary practice location
1330 Boiling Springs Rd
Suite 1600
Spartanburg, SC 29303
Mailing address
1330 Boiling Springs Rd
Suite 1600
Spartanburg, SC 29303
Phone (864) 582-6396
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0408PA | Medicaid | SC |
Other providers in Spartanburg, SC
- Elisha Evette Harris
- Jennifer Erin Harris
- Latirrani Zhane Harris
- Maria L Harris
- Megan Elizabeth Harris
- Nikita Matrice Harrison
- Hart to Heart Therapy LLC
- Hart to Heart Therapy LLC
- Alicia Douglas Hart
- Ashley Hart
All providers in Spartanburg, SC · Surgical Physician Assistant in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 24, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.