Individual provider Active NPI

William T Brand, M.D.

  • Pediatric Otolaryngology Physician
  • Charlottesville, VA
National Provider Identifier
1730404435
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
39348 Issued in SC
Practice address
1204 W Main St FL 6
Charlottesville, VA 22908
Phone
(434) 924-0123
Fax
(434) 924-3300
NPI assigned
Apr 6, 2010
Last updated
Jun 28, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 0101264722 VA
Pediatric Otolaryngology Physician 207YP0228X 39348 SC Primary

Addresses

Primary practice location

1204 W Main St FL 6
Charlottesville, VA 22908

Mailing address

PO Box 9007
Charlottesville, VA 22906-9007
Phone (434) 970-2495

Other identifiers 2

IdentifierTypeStateIssuer
393480MedicaidSC
1730404435MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160831002868 SC Practitioner - Otolaryngology 5092947382 Reassigns benefits to 1 organization
I20180703000218 VA Practitioner - Otolaryngology 5092947382 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101264722VAMDOtolaryngology Physician
39348SCMDPediatric Otolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince Jul 1, 2018 Accepting new patients
Charleston ENT Associates, LLC CurrentSince Aug 1, 2016 Accepting new patients
Charleston ENT Associates, LLC Otolaryngology CurrentSince Aug 1, 2016 Accepting new patients

Locations

1849 Savage Rd
Charleston, SC 29407
Phone (843) 576-2600

2295 Henry Tecklenburg Dr
Charleston, SC 29414

1204 W Main St
Fl 6
Charlottesville, VA 22903
Phone (434) 924-0123

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

Interoperability endpoints

  • Direct secure messaging: wbrand415393@direct.healthsystem.virginia.edu

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1270512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1730404435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229069007",
            "telephone_number": "434-970-2495",
            "fax_number": "434-972-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 W MAIN ST FL 6",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "22908",
            "telephone_number": "434-924-0123",
            "fax_number": "434-924-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAND",
        "first_name": "WILLIAM",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-06",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "VA",
            "license": "0101264722",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "SC",
            "license": "39348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "393480",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730404435",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.