Valjoy Beach Care, P.a.

Key facts

NPI

1154733707

Entity type

Organization (NPI type 2)

Primary specialty

Physician Assistant 363A00000X

Legal business name

VALJOY BEACH CARE, P.A.

Practice address

13500 NC Highway 50 Ste 104
Surf City, NC 28445-7935

Phone

(910) 803-2025

NPI assigned

May 29, 2014

Organization subpart

No

Authorized official

Name

Sandy Margaret Mueller Brady, PA-C NPI 1205879657

Title

Ceo

Phone

(910) 803-2025

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sandy Margaret Mueller-Brady, PA-C Physician Assistant · Surf City, NC · NPI 1205879657
  Medicare reassignment Authorized official NC

Medicare participation

Medicare fee-for-service enrollment

Enrolled in NC

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 30, 2023.

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1154733707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13500 NC HIGHWAY 50 STE 104",
            "city": "SURF CITY",
            "state": "NC",
            "postal_code": "284457935",
            "telephone_number": "910-803-2025",
            "fax_number": "910-803-2027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13500 NC HIGHWAY 50 STE 104",
            "city": "SURF CITY",
            "state": "NC",
            "postal_code": "284457935",
            "telephone_number": "910-803-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALJOY BEACH CARE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-29",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A",
        "authorized_official_last_name": "MUELLER BRADY",
        "authorized_official_first_name": "SANDY",
        "authorized_official_middle_name": "MARGARET",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-803-2025",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154733707",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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