Individual provider Active NPI

Robert Bruce Hanlin, M.D.

  • Family Medicine Physician
  • Greenville, SC
National Provider Identifier
1568410280
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
17177 Issued in SC
Practice address
101 Orchard Park Dr
Greenville, SC 29615-3531
Phone
(864) 729-6606
Fax
(855) 617-4426
NPI assigned
May 5, 2006
Last updated
Dec 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 17177 SC Primary

Addresses

Primary practice location

101 Orchard Park Dr
Greenville, SC 29615-3531

Mailing address

101 Orchard Park Dr
Greenville, SC 29615-3531
Phone (864) 729-6606

Other identifiers 2

IdentifierTypeStateIssuer
171771MedicaidSC
80130814OtherSCRR MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address robert.hanlin@centerwell.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20220124000028 NC Practitioner - Family Practice 2264425529 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17177SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centerwell Senior Primary Care NC JV PC Family Medicine Current Accepting new patients
Centerwell Senior Primary Care (NC) JV, P.C. Family Medicine CurrentSince Feb 1, 2023 Accepting new patients
Centerwell Senior Primary Care NC JV PC Family Medicine CurrentSince Feb 1, 2023 Accepting new patients

Locations

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

8727 Jw Clay Blvd
Charlotte, NC 28262
Phone (980) 999-1831

901 N Wendover Rd
Ste D
Charlotte, NC 28211
Phone (980) 999-3975

2910 E Franklin Blvd
Ste 1
Gastonia, NC 28056
Phone (704) 648-0460

Interoperability endpoints

  • Direct secure messaging: robert.hanlin@centerwell.eclinicaldirectplus.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1568410280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 ORCHARD PARK DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153531",
            "telephone_number": "864-729-6606",
            "fax_number": "855-617-4426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ORCHARD PARK DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153531",
            "telephone_number": "864-729-6606",
            "fax_number": "855-617-4426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANLIN",
        "first_name": "ROBERT",
        "middle_name": "BRUCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "17177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171771",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "80130814",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "robert.hanlin@centerwell.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "101 Orchard Park Dr",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296153531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.