BRIAN J ROBERTS MD (NPI# 1225199094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225199094 |
| Entity Type | Organization |
| Organization Name | BRIAN J ROBERTS MD |
| Other Organization Name | GRAND STAND UROLOGY LLP |
| Practice Address |
823 82nd Pkwy Myrtle Beach SC 29572-4607 |
| Practice Telephone | 8434491010 |
| Practice Fax Number | 8434976171 |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | CHRIS RICHARDSON (EXEC DIR) |
| Authorized Official Telephone | 8434491010 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | 20257 | SC | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP1418 | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 4226216 | 01 |
| Other Name | Type Code |
|---|---|
| GRAND STAND UROLOGY LLP | Doing Business As Name - Organization |
| Street Address |
823 82ND PKWY |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29572-4607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710978903 | William K Bogache | Urology | 823 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2005-11-04 |
| 1700433778 | Lindsey Amanda Rogers | Nurse Practitioner | 823 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2019-08-23 |
| 1497297865 | Renee Flanegan | Nurse Practitioner | 823 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2016-11-16 |
| 1497142863 | Leslie Oleszkowicz | Nurse Practitioner | 823 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2015-04-22 |
| 1659611903 | Christina Nichole Weatherford | Nurse Practitioner | 823 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2013-02-25 |
| 1083980064 | Abhishek Srivastava | Urology | 823 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2012-03-23 |
| 1366744989 | Michelle L. Wirt | Physician Assistant | 823 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2010-12-02 |
| 1316180847 | Robert Jansen | Urology | 823 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2009-04-14 |
| 1982701942 | Lindsay G Nelms | Physician Assistant | 823 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2006-09-20 |
| 1518948587 | Richard W Young | Urology | 823 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2005-11-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684576 | Matthew David Zeuschner | Nurse Practitioner | 107 Woodwind Court, Myrtle Beach, SC 29572 | 2020-09-16 |
| 1578191789 | Julia Ruth Nelson | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center- Gme Office, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2020-04-01 |
| 1407484835 | Justin Schevers | Student in an Organized Health Care Education/Training Program | 802 82nd Parkway, Myrtle Beach, SC 29572 | 2020-03-31 |
| 1922636919 | Darian Michael Quigg | Student in an Organized Health Care Education/Training Program | 809 82nd Street Parkway, Myrtle Beach, SC 29572 | 2020-03-27 |
| 1881221141 | Jonathan Alden Bryan | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2020-03-26 |
| 1215575238 | Polaris Skin Diagnostics, LLC | Dermatology | 8170 Rourk Street, Suite 100, Myrtle Beach, SC 29572 | 2019-12-20 |
| 1700348711 | Five Star Rehabilitation and Wellness Services, LLC. | Clinic/Center | 9547 N Kings Hwy, Myrtle Beach, SC 29572 | 2019-04-01 |
| 1154882975 | Michael Kouandjio | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center-gme Office, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2019-03-26 |
| 1154880102 | Dylan Chase Morgan | Internal Medicine | Grand Strand Medical Center - Gme Office, 809 82nd Pkwy, Myrtle Beach, SC 29572 | 2019-03-19 |
| 1710446828 | David Redding Kingery Jr. | Student in an Organized Health Care Education/Training Program | Gme Office 809 82nd Parkway, Myrtle Beach, SC 29572 | 2019-03-18 |
| Find all providers in zip 29572 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437490257 | Wellnessone, LLC | Non-Pharmacy Dispensing Site | 4736a Highway 17 Byp S, Myrtle Beach, SC 29588-5616 | 2013-03-04 |
| 1871849521 | Coastal Podiatry Associates, Pa | Non-Pharmacy Dispensing Site | 8141 Rourk St, Myrtle Beach, SC 29572-4128 | 2012-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497243588 | Charleston Ent Associates, LLC | Non-Pharmacy Dispensing Site | 2205 2nd Avenue, Summerville, SC 29486 | 2018-04-25 |
| 1962906313 | Charleston Oncology, Pa | Non-Pharmacy Dispensing Site | 3510 Highway 17 Byp N Ste 300, Mount Pleasant, SC 29466-8230 | 2018-03-21 |
| 1811383094 | Charleston Ent Associates, LLC | Non-Pharmacy Dispensing Site | 9185 University Blvd, North Charleston, SC 29406-9120 | 2015-04-14 |
| 1487051439 | Charleston Ent Associates LLC | Non-Pharmacy Dispensing Site | 298 Midland Pkwy, Summerville, SC 29485-8101 | 2014-11-19 |
| 1417367640 | Carolinas Physicians Network, Inc. | Non-Pharmacy Dispensing Site | 1091a 521 Red Ventures Drive, Fort Mill, SC 29707 | 2014-04-28 |
| 1346581162 | Wellness First, LLC | Non-Pharmacy Dispensing Site | 2133 N Hillside Dr, Charleston, SC 29407-8102 | 2013-03-04 |
| 1730440769 | Cigna Onsite Health LLC | Non-Pharmacy Dispensing Site | 2094 Marlboro Rd, Bennettsville, SC 29512 | 2012-06-06 |
| 1679849806 | Florence Podiatry Associates, LLC | Non-Pharmacy Dispensing Site | 492 W Cheves St, Florence, SC 29501-4447 | 2012-04-02 |
| 1629693668 | Anesthesia Associates of Charleston, P.a. | Non-Pharmacy Dispensing Site | 1341 Old Georgetown Rd, Mt Pleasant, SC 29464-7307 | 2020-06-16 |
| 1942841911 | Compounding Center At The Tides | Non-Pharmacy Dispensing Site | 180 Wingo Way Ste 106, Mount Pleasant, SC 29464-1810 | 2019-10-01 |
| Find all providers with the same taxonomy | ||||
| City | MYRTLE BEACH |
| Zip Code | 29572 |
Please comment or provide details below to improve the information on BRIAN J ROBERTS MD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.