Individual provider Active NPI

Bradley Worner, DDS

  • Dentist
  • Greenville, SC
National Provider Identifier
1558815209
Registry record updated Jan 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DGD 8798 Issued in SC
Practice address
4 Market Point Dr
Greenville, SC 29607-6557
Phone
(864) 284-0066
NPI assigned
Aug 11, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DGD 8798 SC Primary

Addresses

Primary practice location

4 Market Point Dr
Greenville, SC 29607-6557

Mailing address

4 Market Point Dr
Greenville, SC 29607-6557
Phone (864) 284-0066

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170223001513 SC Order and Referring Only - DentistPractitioner - Dentist 3173807849

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DGD 8798SCMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1470873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484006400000",
    "number": "1558815209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MARKET POINT DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296076557",
            "telephone_number": "864-284-0066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MARKET POINT DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296076557",
            "telephone_number": "864-284-0066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORNER",
        "first_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-11",
        "last_updated": "2017-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "DGD 8798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.