Organization Active NPI

Brick City Primary Care, PLLC

  • Family Medicine Physician
  • Sanford, NC
National Provider Identifier
1003050238
Registry record updated May 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9700960 Issued in NC
Legal business name
BRICK CITY PRIMARY CARE, PLLC
Practice address
125 Chatham St
Sanford, NC 27330-4335
Phone
(919) 776-7725
Fax
(919) 776-0511
NPI assigned
May 1, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2009

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

Authorized official

Name
Dr. Dana L Garrett, M.D.NPI 1205830239
Title
Partner
Phone
(919) 776-7725

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 9700960 NC Primary

Addresses

Primary practice location

125 Chatham St
Sanford, NC 27330-4335

Mailing address

PO Box 237
Sanford, NC 27331-0237
Phone (919) 776-7725

Other identifiers 2

IdentifierTypeStateIssuer
G38837OtherNCUPIN
8911033MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090618000793 NC Part B Supplier - Clinic/Group Practice 5597816298 Receives reassigned benefits from 2 practitioners
Practice locations: Sanford, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D1104868Brick City Primary Care PLLC125 Chatham St, Sanford, NC 27330Provider-performed microscopySep 10, 2027

National Provider Directory

National Provider Directory

Locations

615 Wicker St
Sanford, NC 27330
Phone (919) 777-0446

125 Chatham St
Sanford, NC 27330
Phone (919) 775-1115

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1241136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241136000000",
    "number": "1003050238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 237",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273310237",
            "telephone_number": "919-776-7725",
            "fax_number": "919-776-0511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 CHATHAM ST",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273304335",
            "telephone_number": "919-776-7725",
            "fax_number": "919-776-0511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRICK CITY PRIMARY CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-01",
        "last_updated": "2009-05-01",
        "status": "A",
        "authorized_official_last_name": "GARRETT",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "919-776-7725",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9700960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "G38837",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8911033",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.