Individual provider Active NPI

Carolyn W Brown, DMD

  • Dentist
  • Columbia, SC
National Provider Identifier
1942470448
Registry record updated Dec 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3357 Issued in SC
Practice address
2000 Clemson Rd
Suite 15
Columbia, SC 29229-9538
Phone
(803) 736-9392
NPI assigned
Mar 11, 2008
Last updated
Dec 2, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3357 SC Primary

Addresses

Primary practice location

2000 Clemson Rd
Suite 15
Columbia, SC 29229-9538

Mailing address

2000 Clemson Rd
Suite 15
Columbia, SC 29229-9538
Phone (803) 736-9392

Other identifiers 1

IdentifierTypeStateIssuer
Z33571MedicaidSC

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170522000222 SC Practitioner - Dentist 3678840782 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3357SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Eau Claire Cooperative Health Center, Inc. CurrentSince Apr 1, 2017 Accepting new patients
Eau Claire Cooperative Health Center ,Inc. CurrentSince Apr 1, 2017 Accepting new patients

Locations

4605 Monticello Rd
Columbia, SC 29203
Phone (803) 252-7001

755 US Highway 21 S
Ridgeway, SC 29130
Phone (803) 337-2920

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228176000000",
    "number": "1942470448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 CLEMSON RD",
            "address_2": "SUITE 15",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292299538",
            "telephone_number": "803-736-9392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 CLEMSON RD",
            "address_2": "SUITE 15",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292299538",
            "telephone_number": "803-736-9392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CAROLYN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-11",
        "last_updated": "2008-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "3357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z33571",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.