Matthew David Bryant, PA-C
Individual provider Active NPI Physician Assistant · Lexington, NC
NPI 1154890838 · NPPES record last updated Nov 25, 2018
Key facts
- NPI
- 1154890838
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 001008498 (NC)
- Practice address
- 104 W Medical Park Dr
Lexington, NC 27292-6773 - Phone
- (336) 224-0931
- Fax
- (336) 224-0932
- NPI assigned
- Nov 25, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200102001535 | NC | Practitioner - Physician Assistant | 8325472160 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001008498 | NC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| High Rock Internal Medicine | Current |
Accepting new patients |
Locations
104 W Medical Park Dr
Lexington, NC 27292
Phone (336) 224-0931
1215 W Clemmonsville Rd
Ste C
Winston Salem, NC 27127
Phone 3362240931 ext. 313
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 001008498 | NC | Yes |
Addresses
Primary practice location
104 W Medical Park Dr
Lexington, NC 27292-6773
Mailing address
104 W Medical Park Dr
Lexington, NC 27292-6773
Phone (336) 224-0931
Other practice location 1
1215 W Clemmonsville Rd Ste C
Winston Salem, NC 27127-4522
Phone (336) 224-0931 ext. 313
Other providers in Lexington, NC
- Faith Ann Broder
- Brookstone Retirement Ctr.,LLC.
- Joanne Brown
- Michael Osborne Brown
- Katelyn Shelton Bruff
- John Glen Buchanan
- Carol A Bullard
- Mary Alisa Bullock
- Emily Grace Burchette
- James Otis Burke Jr.
All providers in Lexington, NC · Physician Assistant in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 25, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.