Individual provider Active NPI

Nikida Bryant, RN

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1063095875
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5021592 Issued in NC
Practice address
13302 Shanagarry Dr
Charlotte, NC 28278-8191
Phone
(336) 769-7939
NPI assigned
Apr 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 250856 NC
Nurse Practitioner 363L00000X 5021592 NC Primary

Addresses

Primary practice location

13302 Shanagarry Dr
Charlotte, NC 28278-8191

Mailing address

13302 Shanagarry Dr
Charlotte, NC 28278-8191
Phone (336) 769-7939

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250723000072 NC Practitioner - Nurse Practitioner 2365958774 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
250856NCMDRegistered Nurse
5021592NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Apr 18, 2025 Accepting new patients

Locations

555 Fayetteville St
Raleigh, NC 27601
Phone (682) 268-1011

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

Organizations & group practices 1

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": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1063095875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13302 SHANAGARRY DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282788191",
            "telephone_number": "336-769-7939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13302 SHANAGARRY DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282788191",
            "telephone_number": "336-769-7939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "NIKIDA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-29",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "250856",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5021592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.