Individual provider Active NPI

Colin Bruce Muncie, M.D.

  • Pediatric Surgery Physician
  • Raleigh, NC
National Provider Identifier
1053750059
Registry record updated Nov 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
2021-01515 Issued in NC
Practice address
23 Sunnybrook Rd
Raleigh, NC 27610-1855
Phone
(919) 350-8797
NPI assigned
Jun 23, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X 2021-01515 NC Primary
Student in an Organized Health Care Education/Training Program 390200000X MS

Addresses

Primary practice location

23 Sunnybrook Rd
Raleigh, NC 27610-1855

Mailing address

2920 Highwoods Blvd
Raleigh, NC 27604-0010
Phone (919) 350-8797

Other practice location 1

2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-5101

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210729000111 NC Practitioner - General Surgery 6800112343 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Wakemed Specialists Group LLC CurrentSince Aug 23, 2021 Accepting new patients
Wakemed Specialists Group, LLC Current Accepting new patients
Wakemed Specialists Group, LLC Pediatric Surgery CurrentSince Aug 23, 2021 Accepting new patients

Locations

120 Healthplex Way
Apex, NC 27502
Phone (919) 235-6525

104 Medspring Dr
Clayton, NC 27520
Phone (919) 235-6422

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

3024 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-5318

10010 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1380

23 Sunnybrook Rd
Raleigh, NC 27610
Phone (919) 322-4800

2920 Highwoods Blvd
Raleigh, NC 27604

Interoperability endpoints

  • Direct secure messaging: cmuncie367145@directhisp.wakemed.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1371945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1053750059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 HIGHWOODS BLVD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276040010",
            "telephone_number": "919-350-8797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 SUNNYBROOK RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101855",
            "telephone_number": "919-350-8797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 N State St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164500",
            "country_code": "US",
            "telephone_number": "601-984-5101",
            "fax_number": "601-984-5110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUNCIE",
        "first_name": "COLIN",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-23",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "NC",
            "license": "2021-01515",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MS",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.