Jessica Brys-Wilson, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

001000252 Issued in NC

Practice address

10589 E NC 97
Rocky Mount, NC 27803-9208

Phone

(252) 442-1807

Fax

(252) 442-1649

NPI assigned

Mar 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334102400000",
    "number": "1356301105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7867",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278040867",
            "telephone_number": "252-442-1807",
            "fax_number": "252-442-1649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10589 E NC 97",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278039208",
            "telephone_number": "252-442-1807",
            "fax_number": "252-442-1649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYS-WILSON",
        "first_name": "JESSICA",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2012-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "001000252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLPATH ID",
            "identifier": "416456",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST ID",
            "identifier": "213660",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA ID",
            "identifier": "7708741",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen B Brown, FNP-BC
• Monique Brown, MD
• Robert Michael Brown Sr., RPH
• Daphne Beauchamp Browne, L.P.T.
• Vernon Bryant
• BTW Home Care Services
• Kerry Camden Bullerdick, M.D.
• Whitney Nicole Bullock, LCSWA
• Betsy D. Bulluck, RD,LDN
• Brenda Burgess

• Medical Physician Assistant in Rocky Mount, NC
• Providers in Rocky Mount, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2012; 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.