Penny Watson Braswell, FNP

Key facts

NPI

1245974336

Entity type

Individual (NPI type 1)

Primary specialty

Family Nurse Practitioner 363LF0000X

License

5016044 (NC)

Practice address

3000 New Bern Ave
Raleigh, NC 27610-1231

Phone

(919) 350-8779

NPI assigned

Apr 25, 2022

Sex

Female

Sole proprietor

No

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.

• Twin River Medical Clinic PC Internal Medicine Physician · Hopewell, VA · NPI 1306805049
  Medicare reassignment Care Compare group NPD VA
• Carolina Rehabilitation and Surgical Associates, PA Physical Medicine & Rehabilitation Physician · Raleigh, NC · NPI 1518913656
  Medicare reassignment NPD NC

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• DLP Maria Parham Medical Center LLC General Acute Care Hospital · Henderson, NC · NPI 1164707725
  Care Compare affiliation Hospital
• DLP Maria Parham Medical Center LLC Psychiatric Hospital Unit · Louisburg, NC · NPI 1689166605
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Twin River Medical Clinic PC (8 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Maria Parham Medical Center Hospital · Henderson, NC · CCN 340132

Medicare participation

Medicare fee-for-service enrollment

Enrolled (2 enrollments) in NC, VA

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: penny.watson.p1@direct.carolinarehab.nextgenshare.com

Specialties & licenses

Addresses

Other names

• Penny Ann Watson Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 27, 2024.

{
    "created_epoch": "1650844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1245974336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3809 COMPUTER DR STE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096518",
            "telephone_number": "919-781-9078"
        },
        {
            "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": "919-350-8779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRASWELL",
        "first_name": "PENNY",
        "middle_name": "WATSON",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-25",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NC",
            "license": "2014-00018",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5016044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PENNY",
            "last_name": "WATSON",
            "middle_name": "ANN",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Jade Elaine Brashear, CRNA
• Alexandra Leigh Braswell, MSW, LCSW
• Phyllis Corey Braswell, R.PH
• Marigny Manson Bratcher, RN
• Leonnie Brathwaite, LMBT, CT
• Edward Charles Bratzke, MD
• Rachel Hallman Bratzke, DPT

All providers in Raleigh, NC · Family Nurse Practitioner in North Carolina