Individual provider Active NPI

Edward Gilbreth, MD

  • Internal Medicine Physician
  • Charleston, SC
National Provider Identifier
1982672358
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
14580 Issued in SC
Practice address
650 Ellis Oak Dr
Charleston, SC 29412-3090
Phone
(843) 762-5480
Fax
(843) 762-5488
NPI assigned
Mar 10, 2006
Last updated
Mar 26, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 14580 SC Primary

Addresses

Primary practice location

650 Ellis Oak Dr
Charleston, SC 29412-3090

Mailing address

PO Box 751357
Charlotte, NC 28275-1357
Phone (843) 722-3621

Other identifiers 1

IdentifierTypeStateIssuer
145809MedicaidSC

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
I20110215000027 SC Practitioner - Internal Medicine 4880874445 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Family Care, Inc CurrentSince Jul 1, 1995 Accepting new patients
Carolina Family Care Inc Internal Medicine CurrentSince Jul 1, 1995 Accepting new patients
Palliative Care at Heart, LLC PastSince Aug 1, 2018 Accepting new patients

Locations

2125 Charlie Hall Blvd
Ste 2B
Charleston, SC 29414
Phone (843) 852-3151

490 Martello Dr
Charleston, SC 29412
Phone (843) 762-4963

650 Ellis Oak Dr
Charleston, SC 29412
Phone (843) 266-1540

1208 Two Island Ct
Mt Pleasant, SC 29466
Phone (843) 884-6653

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": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206489600000",
    "number": "1982672358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751357",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751357",
            "telephone_number": "843-722-3621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 ELLIS OAK DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294123090",
            "telephone_number": "843-762-5480",
            "fax_number": "843-762-5488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBRETH",
        "first_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2008-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "14580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145809",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.