Individual provider Active NPI

William Robert Bixenman, MD

  • Nephrology Physician
  • Rock Hill, SC
National Provider Identifier
1891798740
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
14201 Issued in SC
Practice address
1436 Riverchase Blvd
Rock Hill, SC 29732-1777
Phone
(803) 329-2636
Fax
(803) 329-2184
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 14201 SC Primary

Addresses

Primary practice location

1436 Riverchase Blvd
Rock Hill, SC 29732-1777

Mailing address

1436 Riverchase Blvd
Rock Hill, SC 29732-1777
Phone (803) 329-2636

Other identifiers 2

IdentifierTypeStateIssuer
390000774OtherSCRAILROAD MEDICARE
142018MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14201SCMDOncology Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213574400000",
    "number": "1891798740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1436 RIVERCHASE BLVD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321777",
            "telephone_number": "803-329-2636",
            "fax_number": "803-329-2184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1436 RIVERCHASE BLVD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321777",
            "telephone_number": "803-329-2636",
            "fax_number": "803-329-2184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIXENMAN",
        "first_name": "WILLIAM",
        "middle_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2008-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "SC",
            "license": "14201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "390000774",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142018",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.