Individual provider Active NPI

Reginald R Brannen, D.C.

  • Chiropractor
  • Greenville, SC
National Provider Identifier
1669432191
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2198 Issued in SC
Practice address
530 Howell Rd Ste 100
Greenville, SC 29615-2000
Phone
(864) 268-8196
Fax
(864) 268-8198
NPI assigned
Mar 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2198 SC Primary

Addresses

Primary practice location

530 Howell Rd Ste 100
Greenville, SC 29615-2000

Mailing address

530 Howell Rd Ste 100
Greenville, SC 29615-2000
Phone (864) 268-8196

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061030000255 SC Practitioner - Chiropractic 8628075900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emmanuel Associates LLCGroup PAC ID 2567904592, 4 clinicians

Practice addresses (Care Compare)

530 Howell Rd
Suite 100
Greenville, SC 29615-2000
Phone (864) 268-8196

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2198SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emmanuel Associates LLC Chiropractor CurrentSince Apr 1, 2024 Accepting new patients
Img Clinic PLLC CurrentSince Feb 24, 2022 Accepting new patients

Locations

2510 Wade Hampton Blvd
Ste B
Greenville, SC 29615
Phone (864) 268-8196

530 Howell Rd
Ste 100
Greenville, SC 29615
Phone (864) 268-8196

Interoperability endpoints

  • Direct secure messaging: reginald.brannen.1@17577.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1669432191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 HOWELL RD STE 100",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296152000",
            "telephone_number": "864-268-8196",
            "fax_number": "864-268-8198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 HOWELL RD STE 100",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296152000",
            "telephone_number": "864-268-8196",
            "fax_number": "864-268-8198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANNEN",
        "first_name": "REGINALD",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.