Glenn Clayton Brantley, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

29080 Issued in SC

Practice address

2435 Forest Dr
Columbia, SC 29204-2026

Phone

(803) 865-4934

NPI assigned

Oct 16, 2024

Last updated

Oct 16, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: glenn.brantley.1@7423.direct.athenahealth.com

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.

• Musc Community Physicians

  dba MUSC Community Physicians Specialty

  • Internal Medicine Physician
  • Bamberg, SC
  • NPI 1841878006
  Medicare reassignment NPD
• Musc Community Physicians

  dba MUSC Health Primary Care - Bowman

  • Rural Health Clinic/Center
  • Bowman, SC
  • NPI 1225735772
  NPD
• Musc Community Physicians

  dba MUSC Community Physicians PC

  • Family Medicine Physician
  • Bamberg, SC
  • NPI 1992383145
  NPD

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

{
    "created_epoch": "1729036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1871313544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 LAUREL ST STE 103",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 FOREST DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042026",
            "telephone_number": "803-865-4934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANTLEY",
        "first_name": "GLENN",
        "middle_name": "CLAYTON",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-16",
        "last_updated": "2024-10-16",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "29080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audrey Brannon
• Natasha Rena' Branon, LPC
• Bransand
• Bransand Family Services, LLC
• Kelly Canada Branstetter, CPNP
• Joseph Adams Brantley, D.M.D.
• Ronald Brantley
• Stephanie Brantley, RN
• Rachel Brasell, LMSW
• Monique Yolanda Brashears, RBT

• Nurse Practitioner in Columbia, SC
• Providers in Columbia, SC by specialty
• Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.

Verify at the official NPI Registry.