Carroll Brooks Bannister, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

7718 Issued in SC

Practice address

701 Medical Park Dr
Suite 101
Hartsville, SC 29550-4777

Phone

(843) 339-4295

Fax

(843) 339-4609

NPI assigned

Jul 18, 2006

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

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8689/brand/1/csg/1/fhir/r4

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.

• Hartsville Medical Group LLC

  • Internal Medicine Physician
  • Hartsville, SC
  • NPI 1598995300
  Medicare reassignment NPD
• Hartsville Hma Physician Management Inc

  dba The Medical Group

  • Family Medicine Physician
  • Hartsville, SC
  • NPI 1821021817
  NPD (past)
• Hartsville Surgical Center, LLP

  • Surgery Physician
  • Hartsville, SC
  • NPI 1093760969
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331251200000",
    "number": "1689692253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 MEDICAL PARK DR",
            "address_2": "STE 300",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295504777",
            "telephone_number": "843-878-1101",
            "fax_number": "843-656-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 MEDICAL PARK DR",
            "address_2": "SUITE 101",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295504777",
            "telephone_number": "843-339-4295",
            "fax_number": "843-339-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNISTER",
        "first_name": "CARROLL",
        "middle_name": "BROOKS",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2012-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "7718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "077188",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• App of South Carolina HM PLLC
• Abraham Areephanthu, MD
• Arvind J Bali, M.D.
• Christine Ashley Ballenger, PSY.D.
• Iva Jill Banks, PH.D.
• Gary Barker
• Michael Barr, MD
• Sydney Bates
• Melissa Marie Beach, RN
• Aquilla Bec

• Surgery Physician in Hartsville, SC
• Providers in Hartsville, SC by specialty
• Surgery Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2012; 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.