Active NPI
Brenda Jean Justice, PAC
- Physician Assistant
- Benson, NC
National Provider Identifier
1154516722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 125 E Main St
Benson, NC 27504-1506 - Phone
- (919) 894-3321
- Fax
- (919) 894-8742
- NPI assigned
- Sep 7, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary | ||
| Medical Physician Assistant | 363AM0700X |
Addresses
Primary practice location
125 E Main St
Benson, NC 27504-1506
Mailing address
125 E Main St
Benson, NC 27504-1506
Phone (919) 894-3321
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 179133 | Other | NC | WELLPATH |
| 89012Y9 | Medicaid | NC | |
| 7389999 | Other | NC | MAMSI |
| 012Y9 | Other | NC | BLUE CROSS/BLUE SHIELD |
| 3604325 | Other | NC | CIGNA |
| 89014KX | Medicaid | NC |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189123200000",
"number": "1154516722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 E MAIN ST",
"city": "BENSON",
"state": "NC",
"postal_code": "275041506",
"telephone_number": "919-894-3321",
"fax_number": "919-894-8742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 E MAIN ST",
"city": "BENSON",
"state": "NC",
"postal_code": "275041506",
"telephone_number": "919-894-3321",
"fax_number": "919-894-8742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUSTICE",
"first_name": "BRENDA",
"middle_name": "JEAN",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-07",
"last_updated": "2007-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLPATH",
"identifier": "179133",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89012Y9",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "7389999",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "012Y9",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "3604325",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89014KX",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Benson, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.