Active NPI
Brooke Victoria Hisrich, MD
- Internal Medicine Physician
- Charleston, SC
National Provider Identifier
1790414480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- LL87753
- Practice address
- 169 Ashley Ave Room 202 Main Hospital, MSC 333
Charleston, SC 29425 - Phone
- (843) 792-0435
- NPI assigned
- Jun 8, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | LL87753 | SC | |
| Internal Medicine Physician | 207R00000X | LL87753 | SC | Primary |
Addresses
Primary practice location
169 Ashley Ave Room 202 Main Hospital, MSC 333
Charleston, SC 29425
Mailing address
169 Ashley Ave Room 202 Main Hospital, MSC 333
Charleston, SC 29425
Phone (843) 792-0435
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | hisrich@musc.edu |
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: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221206001824 | SC | Order and Referring Only - Internal Medicine | 1658740113 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL87753 | SC | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654646400000",
"number": "1790414480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "169 ASHLEY AVE ROOM 202 MAIN HOSPITAL, MSC 333",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "29425",
"telephone_number": "843-792-0435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "169 ASHLEY AVE ROOM 202 MAIN HOSPITAL, MSC 333",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "29425",
"telephone_number": "843-792-0435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HISRICH",
"first_name": "BROOKE",
"middle_name": "VICTORIA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-08",
"last_updated": "2022-06-08",
"certification_date": "2022-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "SC",
"license": "LL87753",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "SC",
"license": "LL87753",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "hisrich@musc.edu",
"affiliation": "N",
"endpointDescription": "Email",
"address_1": "169 Ashley Ave Room 202 Main Hospital, MSC 333",
"city": "Charleston",
"state": "SC",
"country_code": "US",
"postal_code": "29425",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.