Individual provider Active NPI

Brandon Thomas Sanford, PHD

  • Psychologist
  • Charleston, SC
National Provider Identifier
1720820806
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1875 Issued in SC
Practice address
30 Bee St
Suite 210
Charleston, SC 29403
Phone
(972) 742-3157
NPI assigned
Jun 10, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1875 SC Primary

Addresses

Primary practice location

30 Bee St
Suite 210
Charleston, SC 29403

Mailing address

PO Box 751461
Charlotte, NC 28275-1461

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.musc.edu Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241008003764 SC Practitioner - Clinical Psychologist 2769913250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1875SCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol CurrentSince Jun 24, 2024 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Jun 24, 2024 Accepting new patients

Locations

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

135 Cannon St
Charleston, SC 29425
Phone (843) 792-9522

30 Bee St
Ste 210
Charleston, SC 29403
Phone (843) 792-6500

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": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1720820806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 BEE ST",
            "address_2": "SUITE 210",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29403",
            "telephone_number": "972-742-3157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANFORD",
        "first_name": "BRANDON",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "SC",
            "license": "1875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "30 Bee St",
            "address_2": "Suite 210",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "29403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.