Brandon Lars Roberg, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1457 Issued in SC

Practice address

6000 Garners Ferry Rd Ste 12
Columbia, SC 29209-1303

Phone

(803) 708-7095

NPI assigned

Sep 8, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Capital City Neuropsychology, LLC

  • Clinical Neuropsychologist
  • Columbia, SC
  • NPI 1801352695
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1504828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680393600000",
    "number": "1649798737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 GARNERS FERRY RD STE 12",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292091303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 GARNERS FERRY RD STE 12",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292091303",
            "telephone_number": "803-708-7095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERG",
        "first_name": "BRANDON",
        "middle_name": "LARS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-08",
        "last_updated": "2023-04-02",
        "certification_date": "2023-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "SC",
            "license": "1457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Joy Roark
• Liana Robbins
• Mary Deane Robbins, LISW-CP
• Megan Dean Robbins, BCBA
• Damion Migal Robbs
• Caroljane Blanchard Roberson, M.D.
• Cristina H Roberson, LISW
• Detris Lashall Roberson, APRN
• Jade E. Roberson, RBT
• Jo Ellen Roberson, RN

• Clinical Psychologist in Columbia, SC
• Providers in Columbia, SC by specialty
• Clinical Psychologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.