Individual provider Active NPI

Brad L Hilaman, MD

  • Gynecology Physician
  • Southport, NC
National Provider Identifier
1255401501
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
9500936 Issued in NC
Practice address
823 N Atlantic Ave
Southport, NC 28461
Phone
(910) 457-9292
Fax
(910) 457-5269
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 9500936 NC Primary

Addresses

Primary practice location

823 N Atlantic Ave
Southport, NC 28461

Mailing address

924 N Howe St
Southport, NC 28461-3038
Phone (910) 457-3806

Other identifiers 1

IdentifierTypeStateIssuer
8942452MedicaidNC

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100923000190 NC Practitioner - Obstetrics/Gynecology 2365568797 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9500936NCMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brad L. Hilaman MD PA Gynecology CurrentSince Jul 20, 2010 Accepting new patients
J. Arthur Dosher Memorial Hospital CurrentSince Nov 1, 2014 Accepting new patients
J. Arthur Dosher Memorial Hospital CurrentSince Jul 1, 2025 Accepting new patients
J. Arthur Dosher Memorial Hospital CurrentSince Nov 1, 2014 Accepting new patients

Locations

4222 Long Beach Rd SE
Ste C
Southport, NC 28461
Phone (910) 454-4728

4222 Long Beach Rd SE
Southport, NC 28461
Phone (910) 269-2053

924 N Howe St
Southport, NC 28461
Phone (910) 457-3800

823 N Atlantic Ave
Southport, NC 28461
Phone (910) 457-3827

821 N Atlantic Ave
Southport, NC 28461
Phone (910) 457-3827

905 N Howe St
Southport, NC 28461
Phone (910) 457-3827

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550534400000",
    "number": "1255401501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 N HOWE ST",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284613038",
            "telephone_number": "910-457-3806",
            "fax_number": "910-457-3842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 N ATLANTIC AVE",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "28461",
            "telephone_number": "910-457-9292",
            "fax_number": "910-457-5269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILAMAN",
        "first_name": "BRAD",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2019-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NC",
            "license": "9500936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8942452",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southport, NC

Sources for this page

Verify at the official NPI Registry.