Individual provider Active NPI

Bruce Bair, PA-C

  • Physician Assistant
  • Chapel Hill, NC
National Provider Identifier
1053308049
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
100385 Issued in NC
Practice address
1728 Fordham Blvd
151 Rams Plaza
Chapel Hill, NC 27514
Phone
(919) 968-1985
Fax
(919) 942-0038
NPI assigned
Oct 4, 2005
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 100385 NC Primary

Addresses

Primary practice location

1728 Fordham Blvd
151 Rams Plaza
Chapel Hill, NC 27514

Mailing address

127 Long Shadow PL
Durham, NC 27713-8639
Phone (919) 632-9589

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
100385NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Raleigh Durham Medical Group PA Past Accepting new patients
Roxboro Family Medicine & Immediate Past Accepting new patients
Henderson Emergency Physicians, PLLC Past Accepting new patients

Organizations & group practices 3

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": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1053308049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 LONG SHADOW PL",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277138639",
            "telephone_number": "919-632-9589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1728 FORDHAM BLVD",
            "address_2": "151 RAMS PLAZA",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "27514",
            "telephone_number": "919-968-1985",
            "fax_number": "919-942-0038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIR",
        "first_name": "BRUCE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "100385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.