Individual provider Active NPI

Brenda Williams Bratton, LPN

  • Licensed Practical Nurse
  • Myrtle Beach, SC
National Provider Identifier
1639830805
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
50522 Issued in SD
Practice address
6681 Wisteria Dr
Myrtle Beach, SC 29588-6481
Phone
(704) 840-5179
NPI assigned
Jan 10, 2022
Last updated
Jan 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 50522 SD Primary

Addresses

Primary practice location

6681 Wisteria Dr
Myrtle Beach, SC 29588-6481

Mailing address

6681 Wisteria Dr
Myrtle Beach, SC 29588-6481
Phone (704) 840-5179

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
50522SDMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1639830805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6681 WISTERIA DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295886481",
            "telephone_number": "704-840-5179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6681 WISTERIA DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295886481",
            "telephone_number": "704-840-5179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRATTON",
        "first_name": "BRENDA",
        "middle_name": "WILLIAMS",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-10",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "SD",
            "license": "50522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.