Individual provider Active NPI

Annette Renae Clark-Brown, M.D.

  • Family Medicine Physician
  • Columbia, SC
National Provider Identifier
1790889178
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
27523 Issued in SC
Practice address
4500 8TH Division Rd
Columbia, SC 29207-5700
Phone
(803) 751-2553
NPI assigned
Sep 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 27523 SC Primary

Addresses

Primary practice location

4500 8TH Division Rd
Columbia, SC 29207-5700

Mailing address

4500 8TH Division Rd
Columbia, SC 29207-5700
Phone (803) 751-2553

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141219000230 SC Order and Referring Only - Family PracticePractitioner - Family Practice 7719042027

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1790889178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 8TH DIVISION RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292075700",
            "telephone_number": "803-751-2553",
            "fax_number": "803-751-0473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 8TH DIVISION RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292075700",
            "telephone_number": "803-751-2553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK-BROWN",
        "first_name": "ANNETTE",
        "middle_name": "RENAE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "27523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.