NPIMap

Individual provider Active NPI

Stephen Alan Bagg, MD

  • Diagnostic Radiology Physician
  • Charleston, SC
National Provider Identifier
1912103722
Registry record updated Feb 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
LL29784 Issued in SC
Practice address
316 Calhoun St
Charleston, SC 29401-1113
Phone
(843) 724-2000
NPI assigned
Jun 27, 2007
Last updated
Feb 13, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X LL29784 SC Primary
Diagnostic Radiology Physician 2085R0202X 200901462 NC

Addresses

Primary practice location

316 Calhoun St
Charleston, SC 29401-1113

Mailing address

PO Box 2363
Indianapolis, IN 46206-2363
Phone (843) 724-2154

Other identifiers 2

IdentifierTypeStateIssuer
297841MedicaidSC
P01200056OtherSCRR MEDICARE SC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130701000259 SC Practitioner - Diagnostic Radiology 6002056728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical University of South Carolina College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roper Radiologists PAGroup PAC ID 6800700162, 40 clinicians

Practice addresses (Care Compare)

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone (843) 402-1783

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200901462NCMDDiagnostic Radiology Physician
LL29784SCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Radiologists PA Diagnostic Radiology CurrentSince Jun 30, 2013 Accepting new patients
Roper Hospital Inc. PastSince Jun 30, 2013 Accepting new patients

Locations

2085 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 577-6957

2085 Henry Tecklenburg Dr
Ste 105
Charleston, SC 29414
Phone (843) 724-2154

2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392249600000",
    "number": "1912103722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2363",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462062363",
            "telephone_number": "843-724-2154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 CALHOUN ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294011113",
            "telephone_number": "843-724-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGG",
        "first_name": "STEPHEN",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-27",
        "last_updated": "2014-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "LL29784",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "200901462",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "297841",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE SC",
            "identifier": "P01200056",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.