NPIMap

Organization Active NPI

Living the Breamedical - Salisbury, PLLC

Doing business as Bream Medical Salisbury

  • Family Medicine Physician
  • Salisbury, NC
National Provider Identifier
1275291361
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LIVING THE BREAMEDICAL - SALISBURY, PLLC
Doing business as
Bream Medical Salisbury
Practice address
721 Grove St
Salisbury, NC 28144-3339
Phone
(252) 702-0267
NPI assigned
Dec 6, 2021
Last updated
Oct 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Authorized official

Name
Pamela H Tucker
Title
Credentialing Specialist
Phone
(336) 210-8409

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

721 Grove St
Salisbury, NC 28144-3339

Mailing address

721 Grove St
Salisbury, NC 28144-3339
Phone (704) 216-1263

Other practice location 1

8422 US 158
Stokesdale, NC 27357

Other practice location 2

8422 US-158
Stokesdale, NC 27357-9247

Other practice location 3

8422 US Highway 158
Stokesdale, NC 27357-9247

Other practice location 4

314 W Queen St
Edenton, NC 27932-1733
Phone (252) 482-3350

Other names 1

  • Bream Medical Salisbury Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220824001984 NC Part B Supplier - Clinic/Group Practice 1951784933 Receives reassigned benefits from 8 practitioners
Practice locations: Edenton, NC; Salisbury, NC; Windsor, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2294772Living the Breamedical-Salisbury, PLLC314 West Queen St, Edenton, NC 27932Certificate of waiverNov 29, 2027

National Provider Directory

National Provider Directory

Locations

314 W Queen St
Edenton, NC 27932
Phone (252) 482-3350

721 Grove St
Salisbury, NC 28144
Phone (704) 216-1263

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1638748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697587200000",
    "number": "1275291361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 GROVE ST",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281443339",
            "telephone_number": "704-216-1263",
            "fax_number": "704-216-1693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 GROVE ST",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281443339",
            "telephone_number": "252-702-0267"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8422 US 158",
            "address_purpose": "LOCATION",
            "city": "Stokesdale",
            "state": "NC",
            "postal_code": "27357",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8422 US-158",
            "address_purpose": "LOCATION",
            "city": "Stokesdale",
            "state": "NC",
            "postal_code": "273579247",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8422 US Highway 158",
            "address_purpose": "LOCATION",
            "city": "Stokesdale",
            "state": "NC",
            "postal_code": "273579247",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "314 W Queen St",
            "address_purpose": "LOCATION",
            "city": "Edenton",
            "state": "NC",
            "postal_code": "279321733",
            "country_code": "US",
            "telephone_number": "252-482-3350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIVING THE BREAMEDICAL - SALISBURY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-06",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "336-210-8409"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bream Medical Salisbury",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salisbury, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.