Individual provider Active NPI

Coty Lamar Brayboy, DNP, MPH, FNP-C

  • Nurse Practitioner
  • Kannapolis, NC
National Provider Identifier
1033838669
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5020423 Issued in NC
Practice address
1706 S Cannon Blvd Ste 101
Kannapolis, NC 28083-6104
Phone
(704) 933-2273
NPI assigned
Aug 25, 2022
Last updated
Mar 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5020423 NC Primary

Addresses

Primary practice location

1706 S Cannon Blvd Ste 101
Kannapolis, NC 28083-6104

Mailing address

1706 S Cannon Blvd Ste 101
Kannapolis, NC 28083-6104
Phone (704) 933-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, IA, MO3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20250423003219 NC Practitioner - Nurse Practitioner 9638695521 Reassigns benefits to 1 organization
I20250929003012 IA Practitioner - Nurse Practitioner 9638695521 Reassigns benefits to 1 organization
I20250929003199 MO Practitioner - Nurse Practitioner 9638695521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indycare Medical North CarolinaGroup PAC ID 1658616362, 7 clinicians

Practice addresses (Care Compare)

1706 S Cannon Blvd
Suite 101
Kannapolis, NC 28083-6104
Phone (704) 933-2273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5020423NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Indycare Carelink PC CurrentSince Jul 13, 2025 Accepting new patients
Indycare Medical North Carolina CurrentSince Dec 1, 2024 Accepting new patients

Locations

1800 Main St
Gowrie, IA 50543
Phone (515) 352-3876

601 State Route 28 E
Owensville, MO 65066
Phone (573) 437-3440

110 Boone Square St
Ste 29A
Hillsborough, NC 27278
Phone (919) 245-1213

1706 S Cannon Blvd
Ste 100
Kannapolis, NC 28083

1706 S Cannon Blvd
Ste 101
Kannapolis, NC 28083
Phone (703) 933-2273

Interoperability endpoints

  • Direct secure messaging: coty.brayboy.1@18181.direct.athenahealth.com
  • Direct secure messaging: coty.brayboy.3@18181.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/18181/brand/1/csg/121/fhir/r4

Organizations & group practices 2

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": "1661385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1033838669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 S CANNON BLVD STE 101",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280836104",
            "telephone_number": "704-933-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 S CANNON BLVD STE 101",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280836104",
            "telephone_number": "704-933-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAYBOY",
        "first_name": "COTY",
        "middle_name": "LAMAR",
        "name_prefix": "Dr.",
        "credential": "DNP, MPH, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-25",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5020423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kannapolis, NC

Sources for this page

Verify at the official NPI Registry.