Individual provider Active NPI

Bradley Dargan Flowers, D.M.D.

  • Dentist
  • Hartsville, SC
National Provider Identifier
1578827218
Registry record updated Jun 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DGD.8087 GD Issued in SC
Practice address
756 W Carolina Ave
Hartsville, SC 29550-4412
Phone
(843) 332-0623
Fax
(843) 917-0454
NPI assigned
Jun 27, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2012

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.8087 GD SC Primary

Addresses

Primary practice location

756 W Carolina Ave
Hartsville, SC 29550-4412

Mailing address

756 W Carolina Ave
Hartsville, SC 29550-4412
Phone (843) 332-0623

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
I20150717000073 SC Order and Referring Only - DentistPractitioner - Dentist 7719290931

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8087SCMDProfessional Counselor
DGD.8087 GDSCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
K. Dargan Flowers, Jr. D.M.D. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340755200000",
    "number": "1578827218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "756 W CAROLINA AVE",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295504412",
            "telephone_number": "843-332-0623",
            "fax_number": "843-917-0454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "756 W CAROLINA AVE",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295504412",
            "telephone_number": "843-332-0623",
            "fax_number": "843-917-0454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOWERS",
        "first_name": "BRADLEY",
        "middle_name": "DARGAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-27",
        "last_updated": "2012-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "DGD.8087 GD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartsville, SC

Sources for this page

Verify at the official NPI Registry.