Brian Yongjin Pak

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

100 Brunswick Medical Center Pkwy NE
Bolivia, NC 28422-1001

Phone

(910) 253-9000

Fax

(910) 253-9033

NPI assigned

Mar 11, 2022

Last updated

Mar 11, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1646956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1073261798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 MACGREGOR DOWNS RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345925",
            "telephone_number": "910-253-9000",
            "fax_number": "910-253-9033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BRUNSWICK MEDICAL CENTER PKWY NE",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284221001",
            "telephone_number": "910-253-9000",
            "fax_number": "910-253-9033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAK",
        "first_name": "BRIAN",
        "middle_name": "YONGJIN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-11",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maureen E O'Brien, P.T.
• Jaclyn J Oehler, MS, CCC-SLP
• Sabrina Rohanie Officer, DMD
• Sarah E Oxford, A.M.H.P.
• Lisa K Paitsel, PA
• James Bryant Pate, APRN
• Cayce McCall Patterson
• Annemarie Petty, OTR/L
• Debbora Kay Pittman, LCMHC
• Michele Polidoro, MD

• Student in an Organized Health Care Education/Training Program in Bolivia, NC
• Providers in Bolivia, NC by specialty
• Student in an Organized Health Care Education/Training Program in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; 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.