Individual provider Active NPI

Bassam E Haddad, M.D.

  • Family Medicine Physician
  • Greenville, SC
National Provider Identifier
1790949790
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
31026 Issued in SC
Practice address
2076 Woodruff Rd
Greenville, SC 29607-5939
Phone
(864) 373-7246
NPI assigned
Jul 18, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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 31026 SC Primary

Addresses

Primary practice location

2076 Woodruff Rd
Greenville, SC 29607-5939

Mailing address

1120 Sparkleberry Lane Ext Ste a
Columbia, SC 29223-7078
Phone (803) 851-0605

Other practice location 1

129 S Broad St
Clinton, SC 29325-2543
Phone (864) 547-1294

Other practice location 2

400 N Fant St Ste E
Anderson, SC 29621-5720
Phone (864) 328-9250

Other practice location 3

1120 Sparkleberry Lane Ext Ste A
Columbia, SC 29223-7078
Phone (803) 851-0605

Other identifiers 2

IdentifierTypeStateIssuer
31026OtherSCMED LICENSE
PG1133MedicaidSC

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
I20111013000293 SC Practitioner - Family Practice 2860664901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
We Care Family Health, LLCGroup PAC ID 2668854324, 3 clinicians

Practice addresses (Care Compare)

1120 Sparkleberry Lane Ext
Suite a
Columbia, SC 29223-7078
Phone (803) 851-0605

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31026SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
We Care Family Health LLC Family Medicine CurrentSince Jul 21, 2022 Accepting new patients
Woodruff Road Urgent Care Center, P.C. PastSince Dec 29, 2019 Accepting new patients

Locations

400 N Fant St
Ste E
Anderson, SC 29621
Phone (864) 224-8883

129 S Broad St
Clinton, SC 29325
Phone (864) 547-1294

1120 Sparkleberry Lane Ext
Ste A
Columbia, SC 29223
Phone (276) 613-4111

2076 Woodruff Rd
Greenville, SC 29607
Phone (864) 261-9506

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1790949790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 SPARKLEBERRY LANE EXT STE A",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292237078",
            "telephone_number": "803-851-0605",
            "fax_number": "866-291-3617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2076 WOODRUFF RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075939",
            "telephone_number": "864-373-7246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "129 S Broad St",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "SC",
            "postal_code": "293252543",
            "country_code": "US",
            "telephone_number": "864-547-1294",
            "fax_number": "866-291-3617",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 N Fant St Ste E",
            "address_purpose": "LOCATION",
            "city": "Anderson",
            "state": "SC",
            "postal_code": "296215720",
            "country_code": "US",
            "telephone_number": "864-328-9250",
            "fax_number": "866-291-3617",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1120 Sparkleberry Lane Ext Ste A",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292237078",
            "country_code": "US",
            "telephone_number": "803-851-0605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HADDAD",
        "first_name": "BASSAM",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-18",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "31026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED LICENSE",
            "identifier": "31026",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PG1133",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.