Active NPI
Bradley C Brenton, M.D.
- Body Imaging Physician
- Goldsboro, NC
National Provider Identifier
1083676738
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Body Imaging Physician
- License
- 24637
- Practice address
- 2700 Medical Office PL
Goldsboro, NC 27534-9460 - Phone
- (919) 734-1866
- Fax
- (919) 736-1804
- NPI assigned
- Apr 6, 2006
- Last updated
- Nov 29, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Body Imaging Physician | 2085B0100X | 24637 | NC | Primary |
Addresses
Primary practice location
2700 Medical Office PL
Goldsboro, NC 27534-9460
Mailing address
PO Drawer 1757
Goldsboro, NC 27533
Phone (919) 734-1866
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14876 | Other | NC | BCBS NC STATE |
| 8914876 | Medicaid | NC | |
| 02898 | Other | NC | WORK COMP |
| 14876 | Other | NC | BCBS |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24637 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322524800000",
"number": "1083676738",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO DRAWER 1757",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "27533",
"telephone_number": "919-734-1866",
"fax_number": "919-736-1804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 MEDICAL OFFICE PL",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "275349460",
"telephone_number": "919-734-1866",
"fax_number": "919-736-1804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENTON",
"first_name": "BRADLEY",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-06",
"last_updated": "2011-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "2085B0100X",
"taxonomy_group": "",
"desc": "Radiology, Body Imaging",
"state": "NC",
"license": "24637",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NC STATE",
"identifier": "14876",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8914876",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WORK COMP",
"identifier": "02898",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "14876",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Goldsboro, NC
- Amy G. E. Brantley, PA
- Philip K Brantly, DDS
- Breath of Life, Inc.
- Anissa Sheree Breland, DNP, CRNA
- Brenda a. Taylor
- Hannah Elisabeth Brewer, SLP
- Albert L Bridger, PA-C
- Bridges of Hope Inc
- Bridgewell Residential Services, LLC (BridgeWell Residential Services)
- Bridging the Gap Home Health Care Services, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.