Individual provider Active NPI

Stephen Whitney Bryan, FNP-C

  • Family Nurse Practitioner
  • Shelby, NC
National Provider Identifier
1124783626
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5015213 Issued in NC
Practice address
711 N Dekalb St
Shelby, NC 28150-3911
Phone
(704) 482-1482
NPI assigned
Nov 1, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5015213 NC Primary

Addresses

Primary practice location

711 N Dekalb St
Shelby, NC 28150-3911

Mailing address

111 Highland Pines Dr
Shelby, NC 28152-8165
Phone (704) 472-0645

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
I20220125001819 NC Practitioner - Nurse Practitioner 7719379791 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT Carolina PAGroup PAC ID 1456363407, 14 clinicians

Practice addresses (Care Compare)

2520 Aberdeen Blvd
Gastonia, NC 28054-0635
Phone (704) 868-8400

Hospital & facility affiliations

  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
ENT Carolina PA CurrentSince Jun 15, 2022 Accepting new patients
ENT Carolina PA Past Accepting new patients

Locations

2520 Aberdeen Blvd
Gastonia, NC 28054
Phone (704) 868-8400

1180 Wyke Rd
Shelby, NC 28150
Phone (704) 487-9100

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: sbryan975888@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 2

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 6

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": "1635724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1124783626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 HIGHLAND PINES DR",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281528165",
            "telephone_number": "704-472-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 N DEKALB ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503911",
            "telephone_number": "704-482-1482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "STEPHEN",
        "middle_name": "WHITNEY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-01",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5015213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, NC

Sources for this page

Verify at the official NPI Registry.