Active NPI
Michael David Brown, MD
- Pediatrics Physician
- Raleigh, NC
National Provider Identifier
1134412943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2015-00142
- Practice address
- 3000 New Bern Ave
Raleigh, NC 27610-1231 - Phone
- (919) 350-8000
- NPI assigned
- May 26, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD451589 | PA | |
| Pediatrics Physician | 208000000X | 2015-00142 | NC | Primary |
Addresses
Primary practice location
3000 New Bern Ave
Raleigh, NC 27610-1231
Mailing address
PO Box 603949
Charlotte, NC 28260-3949
Phone (919) 350-0351
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134412943 | Medicaid | NC |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mbrown14665@directHISP.wakemed.org | Direct |
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD451589 | PA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wakemed Specialists Group, LLC | Current | Accepting new patients | |
| Southeastern Regioinal Medical Center | Pediatrics | Current | Accepting new patients |
| North Carolina MG, LLC | Current | Accepting new patients | |
| Southeastern Regional Medical Center | Current | Accepting new patients | |
| Southeastern Regional Medical Center | Current | Accepting new patients | |
| Wakemed Specialists Group LLC | Current | Accepting new patients |
Locations
120 Healthplex Way
Apex, NC 27502
Phone (919) 235-6525
300 W 27th St
Lumberton, NC 28358
Phone (910) 671-5000
3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000
Interoperability endpoints
- mbrown14665@directhisp.wakemed.org
Organizations & group practices 6
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.
-
- Clinic/Center
- Lumberton, NC
- NPI 1154399699
-
- Cardiovascular Disease Physician
- Raleigh, NC
- NPI 1588227839
-
- Hospitalist Physician
- Raleigh, NC
- NPI 1215741640
-
- Pediatrics Physician
- Lumberton, NC
- NPI 1326816877
-
- Diagnostic Radiology Physician
- Lumberton, NC
- NPI 1932089612
-
- Cardiac Rehabilitation Registered Nurse
- Raleigh, NC
- NPI 1063304228
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716422400000",
"number": "1134412943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 603949",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282603949",
"telephone_number": "919-350-0351",
"fax_number": "919-350-7687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 NEW BERN AVE",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276101231",
"telephone_number": "919-350-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "MICHAEL",
"middle_name": "DAVID",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-05-26",
"last_updated": "2024-05-23",
"certification_date": "2024-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MD451589",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "2015-00142",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1134412943",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mbrown14665@directHISP.wakemed.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "XML",
"address_1": "3000 New Bern Ave",
"city": "Raleigh",
"state": "NC",
"country_code": "US",
"postal_code": "276101231",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.