Individual provider Active NPI

Larry Jason Byrd, FNP

  • Nurse Practitioner
  • Wilmington, NC
National Provider Identifier
1083663454
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0002-01782 Issued in NC
Practice address
1814 New Hanover Medical Park Dr
Wilmington, NC 28403-5350
Phone
(910) 662-8765
Fax
(910) 362-9123
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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 0002-01782 NC Primary

Addresses

Primary practice location

1814 New Hanover Medical Park Dr
Wilmington, NC 28403-5350

Mailing address

PO Box 936857
Atlanta, GA 31193-6857
Phone (910) 662-8765

Other practice location 1

201 Queens Rd
Charlotte, NC 28204-3217
Phone (704) 372-5180

Other identifiers 1

IdentifierTypeStateIssuer
P00283215OtherRAILRAD MEDICARE

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
I20040421001469 NC Practitioner - Nurse Practitioner 8921093626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1814 New Hanover Medical Park Dr
Wilmington, NC 28403-5350
Phone (910) 662-8765

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0002-01782NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group Coastal Region, LLC Current Accepting new patients
NMG Health Services LLC CurrentSince Oct 18, 2022 Accepting new patients
Novant Health Medical Group Coastal Region, LLC CurrentSince Oct 18, 2022 Accepting new patients
Mid-Atlantic Emergency Medical Associates, PLLC Past Accepting new patients

Locations

1333 S Dickinson Dr
Unit 230
Leland, NC 28451
Phone (910) 254-1033

800 Jefferson St
Ste 112
Whiteville, NC 28472
Phone (910) 642-8164

1814 New Hanover Medical Park Dr
Wilmington, NC 28403
Phone (910) 452-3666

Interoperability endpoints

  • Direct secure messaging: lbyrd46174@direct.novanthealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1083663454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936857",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936857",
            "telephone_number": "910-662-8765",
            "fax_number": "910-362-9123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 NEW HANOVER MEDICAL PARK DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035350",
            "telephone_number": "910-662-8765",
            "fax_number": "910-362-9123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Queens Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282043217",
            "country_code": "US",
            "telephone_number": "704-372-5180",
            "fax_number": "704-337-8387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BYRD",
        "first_name": "LARRY",
        "middle_name": "JASON",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "0002-01782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILRAD MEDICARE",
            "identifier": "P00283215",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.