Dakota Griffin Brunswick, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1010856 Issued in NC

Practice address

280 Executive Park Dr Ste 100
Concord, NC 28025-1838

Phone

(237) 424-0704

NPI assigned

Jan 29, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1275124596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3808 RIVERBEND RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282106822",
            "telephone_number": "336-905-0685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 EXECUTIVE PARK DR STE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251838",
            "telephone_number": "237-424-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNSWICK",
        "first_name": "DAKOTA",
        "middle_name": "GRIFFIN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-29",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "1010856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "@cehcharlotte",
            "affiliation": "N",
            "address_1": "280 Executive Park Dr Ste 100",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280251838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Vincent David Brown, D.C.
• Katherine Leigh Broyhill, MS, CGC
• Carlton James Bruce, DMD
• Jill McAllister Brumfield, NP
• Shaquila O'Shay Renee Brummitt, MSW, LCSW
• Valerie Brust
• Morgan Bruton
• Bryan T. Persinger DDS PA
• Makayla Bryant, LCSWA
• Pier Bryant, LCSW

• Physician Assistant in Concord, NC
• Providers in Concord, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.