Individual provider Active NPI

Brandi Leigh Fowler, NP-C

  • Family Nurse Practitioner
  • Murrells Inlet, SC
National Provider Identifier
1629623202
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
22994 Issued in SC
Practice address
9405 Highway 17 Byp
Murrells Inlet, SC 29576-9301
Phone
(843) 650-2213
NPI assigned
Aug 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 22994 SC Primary

Addresses

Primary practice location

9405 Highway 17 Byp
Murrells Inlet, SC 29576-9301

Mailing address

9021 Bella Verde CT
Myrtle Beach, SC 29579-5110

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Nhccare

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200122000157 SC Practitioner - Nurse Practitioner 8921433905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Supportive Care of South Carolina LLCGroup PAC ID 7618352451, 32 clinicians

Practice addresses (Care Compare)

101 Brightwater Dr
Myrtle Beach, SC 29579-8275
Phone (718) 298-4375

Merit-based Incentive Payment System (MIPS)

Final score
95.24 of 100Reported as group
Quality
86.38
Improvement activities
40
Cost
73.95

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
22994SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Care of South Carolina LLC CurrentSince Oct 22, 2023 Accepting new patients
Medicos, P.a. PastSince Feb 11, 2024 Accepting new patients

Locations

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 2

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": "1565308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1629623202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9021 BELLA VERDE CT",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295795110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9405 HIGHWAY 17 BYP",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295769301",
            "telephone_number": "843-650-2213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "BRANDI",
        "middle_name": "LEIGH",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-09",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "22994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Nhccare",
            "affiliation": "N",
            "address_1": "9405 Highway 17 Byp",
            "city": "Murrells Inlet",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295769301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Murrells Inlet, SC

Sources for this page

Verify at the official NPI Registry.