Active NPI
Chalbourne Rutledge Brasington, D.M.D.
- Endodontics
- Greenville, SC
National Provider Identifier
1689724973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 3766
- Practice address
- 133 Bennett St
Greenville, SC 29601-1605 - Phone
- (864) 412-1007
- Fax
- (864) 412-1009
- NPI assigned
- Jan 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 3766 | SC | Primary |
Addresses
Primary practice location
133 Bennett St
Greenville, SC 29601-1605
Mailing address
133 Bennett St
Greenville, SC 29601-1605
Phone (864) 412-1007
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZX3766 | Medicaid | SC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3766 | SC | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376611200000",
"number": "1689724973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "133 BENNETT ST",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296011605",
"telephone_number": "864-412-1007",
"fax_number": "864-412-1009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "133 BENNETT ST",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296011605",
"telephone_number": "864-412-1007",
"fax_number": "864-412-1009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRASINGTON",
"first_name": "CHALBOURNE",
"middle_name": "RUTLEDGE",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-11",
"last_updated": "2013-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "SC",
"license": "3766",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZX3766",
"state": "SC"
}
],
"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 Aug 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.