Grayson Brent Mayberry

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-11780 Issued in NC

Practice address

1415 Physicians Dr
Wilmington, NC 28401-7338

Phone

(910) 662-9500

Fax

(910) 662-9501

NPI assigned

Jul 12, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Medical Group Coastal Region LLCGroup PAC ID 2860809936, 577 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health New Hanover Regional Medical Center Hospital, Wilmington, NC, CCN 340141
• Columbus Regional Healthcare System Hospital, Whiteville, NC, CCN 340068
• Novant Health Brunswick Medical Center Hospital, Supply, NC, CCN 340158

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Novant Health Medical Group Coastal Region, LLC

  dba NHMGCR Cape Fear Heart

  • Cardiovascular Disease Physician
  • Wilmington, NC
  • NPI 1649865791
  Medicare reassignment Care Compare group
• East Carolina Anesthesia Associates, PLLC

  • Anesthesiology Physician
  • Greenville, NC
  • NPI 1205996519
  Medicare reassignment
• NMG Health Services LLC

  • Maternal & Fetal Medicine Physician
  • Bolivia, NC
  • NPI 1558242495
  NPD
• Novant Health Medical Group Coastal Region, LLC

  dba Wrightsville Beach Family Medicine

  • Family Medicine Physician
  • Wilmington, NC
  • NPI 1447830054
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Brunswick Community Hospital, LLC

  dba Novant Health Brunswick Medical Center

  • General Acute Care Hospital
  • Bolivia, NC
  • NPI 1710915756
  Care Compare affiliation
• Columbus Regional Healthcare System

  dba South Columbus Medical Clinic

  • General Acute Care Hospital
  • Whiteville, NC
  • NPI 1376537555
  Care Compare affiliation
• Novant Health New Hanover Regional Medical Center LLC

  dba Novant Health New Hanover Regional Medical Center

  • General Acute Care Hospital
  • Wilmington, NC
  • NPI 1376139139
  Care Compare affiliation

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

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1013589886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936857",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 PHYSICIANS DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017338",
            "telephone_number": "910-662-9500",
            "fax_number": "910-662-9501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYBERRY",
        "first_name": "GRAYSON",
        "middle_name": "BRENT",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-12",
        "last_updated": "2022-01-19",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-11780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maxim Healthcare Services, Inc.
• Maxim Healthcare Services, Inc.
• Sara Maxwell
• Jeannine Meece May
• Michael F May, MSW LCAS-A
• Louise Ann Mayer, RBT
• Crystal Mayfield
• Joe D Mayfield, CRNA
• Lou A Mayfield, CRNA
• Annette Kathleen Maynard, PT

• Physician Assistant in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.