Johnathan Antonio Brunson, LCAS-A

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

3011 NC Highway 42 W
Suite G
Wilson, NC 27893

Phone

(252) 991-3985

Fax

(252) 991-3993

NPI assigned

Jun 6, 2016

Sex

Male

Sole proprietor

No

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.

• B & D Integrated Health Services East Inc

  • Community/Behavioral Health Agency
  • Goldsboro, NC
  • NPI 1194567461
  NPD (past)
• One to One With Youth, Inc.

  • Community/Behavioral Health Agency
  • Goldsboro, NC
  • NPI 1861587867
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 4, 2020.

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1124477658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 BEECH ST",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275302818",
            "telephone_number": "919-731-2119",
            "fax_number": "919-739-4989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 NC HIGHWAY 42 W",
            "address_2": "SUITE G",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "27893",
            "telephone_number": "252-991-3985",
            "fax_number": "252-991-3993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNSON",
        "first_name": "JOHNATHAN",
        "middle_name": "ANTONIO",
        "credential": "LCAS-A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-06",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Brooks, FNP-C
• Janelle Brown Taft, MSN, FNP-C
• Ashlei Brown
• Richard Everit Brown, M.D.
• Jennifer Rose Bruckstein, PA-C
• David Allen Bryant
• Haley Bryant, RDN
• Kenneth Wayne Bryant Jr., LPC A
• Nicole Horne Bryant
• John H Buck, MD

• All providers in Wilson, NC
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; 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.