Brandi Kay Alt, D.O.
Individual provider Active NPI Obstetrics & Gynecology Physician · Greenville, SC
NPI 1699895409 · NPPES record last updated Jun 26, 2015
Key facts
- NPI
- 1699895409
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- LL760 (SC)
- Practice address
- 124 Verdae Blvd.
Suite 204
Greenville, SC 29607 - Phone
- (864) 271-9780
- Fax
- (864) 271-9785
- NPI assigned
- Mar 29, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- West Virginia School of Osteopathic Medicine, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bon Secours Medical Group Greenville Specialty Care LLC
Practice addresses (Care Compare)
1011 Tiger Blvd
Suite 100
Clemson, SC 29631-1401
Phone (864) 654-9053
135 Commonwealth Dr
Suite 300
Greenville, SC 29615-4860
Phone (864) 271-9780
317 Saint Francis Dr
Suite 220
Greenville, SC 29601-3976
Phone (864) 255-1901
Hospital & facility affiliations
- St Francis-Downtown
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071010000738 | SC | Practitioner - Obstetrics/Gynecology | 7315033016 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL760 | SC | MD | Obstetrics & Gynecology Physician |
| 760 | SC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bon Secours Medical Group Greenville Specialty Care LLC | Obstetrics & Gynecology | Current |
Accepting new patients |
| Bon Secours Medical Group Greenville Specialty Care LLC | Current |
Accepting new patients | |
| St Francis Physician Services Inc | Obstetrics & Gynecology | Past | Accepting new patients |
Locations
1011 Tiger Blvd
Ste 100
Clemson, SC 29631
Phone (864) 382-4035
317 Saint Francis Dr
Ste 220
Greenville, SC 29601
Phone (864) 255-1901
135 Commonwealth Dr
Ste 3
Greenville, SC 29615
124 Verdae Blvd
Ste 204
Greenville, SC 29607
Phone (864) 271-9780
Interoperability endpoints
- balt1149018@direct.bsmhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | LL760 | SC | Yes |
Addresses
Primary practice location
124 Verdae Blvd.
Suite 204
Greenville, SC 29607
Mailing address
124 Verdae Blvd.
Suite 204
Greenville, SC 29607
Phone (864) 271-9780
Other providers in Greenville, SC
- Laura Marcela Alonso-Price
- Ryan Alonso
- Alpha Care Case Management LLC
- Alpha One Home Meals
- Raquna Alston
- Alternative Youth Services, Inc.
- Alyssa Davies Althoff
- Anna Alvarado
- Idsi Danil Alvarez Martinez
- Juan Carlos Alvarez Moreno
All providers in Greenville, SC · Obstetrics & Gynecology Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.