BRAIN RESTORATION CLINIC, PLLC (NPI# 1871912667) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871912667 |
| Entity Type | Organization |
| Organization Name | BRAIN RESTORATION CLINIC, PLLC |
| Practice Address |
1040 Edgewater Corp Pkwy Suite 106 Indian Land SC 29707-4514 |
| Practice Telephone | 7045419117 |
| Practice Fax Number | 7045419137 |
| Mailing Telephone | 7045419117 |
| Mailing Fax Number | 7045419137 |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2015-08-05 |
| Authorized Official Name | DR. JEAN-RONEL CORBIER (OWNER) |
| Authorized Official Telephone | 7045419117 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
200601910 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5905648 | 05 |
| Street Address |
1040 EDGEWATER CORP PKWY SUITE 106 |
| City | INDIAN LAND |
| State | SC |
| Zip Code | 29707-4514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225193105 | Jean-ronel Corbier | Pediatrics | 1040 Edgewater Corp Pkwy, Suite 106, Indian Land, SC 29707-4514 | 2006-12-22 |
| 1962720342 | Karen E Preston | Nurse Practitioner | 1040 Edgewater Corp Pkwy, Suite 106, Indian Land, SC 29707-4514 | 2010-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535844 | Anomaly Bodywork & Wellness Center, LLC | Massage Therapist | 4068 Flats Main Street, Apt 100, Indian Land, SC 29707 | 2020-10-15 |
| 1164034369 | Renu Kapoor Virdi | Dentist | 9709 Redstone Dr, Ste 500, Indian Land, SC 29707 | 2020-08-19 |
| 1205467420 | Brian Keith Sutton | Physical Therapist | 2021 Bridgemill Dr, Ste 106, Indian Land, SC 29707 | 2020-01-27 |
| 1215575774 | Doby's Bridge Dentistry | Dentist | 4174 Dobys Brige Road Ste 100, Indian Land, SC 29707 | 2019-12-16 |
| 1346895141 | Redstone Modern Dentistry, PC | Dentist | 9709 Redstone Dr., Suite 500, Indian Land, SC 29707 | 2019-08-08 |
| 1396228698 | Daniel Allen | Massage Therapist | 4068 Flats Main St, Apt 100, Indian Land, SC 29707 | 2018-09-12 |
| 1598269409 | Dawn K Beatty-batten | Occupational Therapy Assistant | The Blake At Edgewater, 1099 Edgewater Corporate Parkway, Indian Land, SC 29707 | 2018-03-23 |
| 1366940959 | Kds Consultants, LLC | Family Medicine | 8351 Charlotte Hwy Ste 200, Indian Land, SC 29707 | 2018-01-29 |
| 1093227464 | Ivision Associates LLC | Optometrist | 9700 Red Stone Drive Suite 300, Indian Land, SC 29707 | 2017-10-25 |
| 1396274742 | Carson Tyler Mcginn | Specialist/Technologist | 8690 Henry Harris Rd., Fort Mill, SC 29707 | 2017-06-08 |
| Find all providers in zip 29707 | ||||
| Taxonomy Code | 2084N0402X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology with Special Qualifications in Child Neurology |
| A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376938936 | Adrienne B Bruce | Psychiatry & Neurology | 110 Jervey Rd, Greenville, SC 29609-1342 | 2015-03-31 |
| 1710918230 | Spartanburg Regional Med Ctr | Psychiatry & Neurology | 853 N Church Street, Suite 640, Spartanburg, SC 29303-3040 | 2006-07-05 |
| 1174561864 | Augusto Morales | Psychiatry & Neurology | 200 Patewood Dr Ste A350, Greenville, SC 29615-3547 | 2006-06-03 |
| 1982642237 | Robert P Turner | Psychiatry & Neurology | 1941 Savage Rd, Suite 100-e, Charleston, SC 29407-4704 | 2006-06-02 |
| 1528683349 | Katherine Braun Horman | Psychiatry & Neurology | 169 Ashley Ave Rm 202, Charleston, SC 29425-8905 | 2020-06-09 |
| 1356605844 | Sonal Bhatia | Psychiatry & Neurology | 171 Ashley Ave, Charleston, SC 29425 | 2012-06-28 |
| 1700143344 | Liliana Banari | Psychiatry & Neurology | 171 Ashley Ave, Charleston, SC 29425-0001 | 2012-04-20 |
| 1427357219 | Sunjay Ryan Nunley | Psychiatry & Neurology | 200 Patewood Dr Ste A350, Greenville, SC 29615-3547 | 2011-03-20 |
| 1861710527 | Michael Arthur Babcock | Psychiatry & Neurology | 200 Patewood Dr, Suite A350, Greenville, SC 29615-3593 | 2010-05-05 |
| 1770736621 | University Medical Associates | Psychiatry & Neurology | 171 Ashley Ave, Charleston, SC 29425-8908 | 2008-10-23 |
| Find all providers with the same taxonomy | ||||
| City | INDIAN LAND |
| Zip Code | 29707 |
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| 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.