NPIMap

Individual provider Active NPI

Bradford W Lawrence, PA-C

  • Physician Assistant
  • Hickory, NC
National Provider Identifier
1376505651
Registry record updated Feb 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
101975 Issued in NC
Practice address
5045 Hickory Blvd
Hickory, NC 28601-8920
Phone
(828) 212-1020
Fax
(828) 212-1024
NPI assigned
Apr 4, 2006
Last updated
Feb 22, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 101975 NC Primary

Addresses

Primary practice location

5045 Hickory Blvd
Hickory, NC 28601-8920

Mailing address

PO Box 509
Sylva, NC 28779-0509
Phone (828) 339-7268

Other identifiers 1

IdentifierTypeStateIssuer
155KEOtherNCBCBS NC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040115000726 NC Practitioner - Physician Assistant 7719888544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wake Forest University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catawba Valley Medical Group IncGroup PAC ID 6305007279, 133 clinicians

Practice addresses (Care Compare)

50 Macedonia Church Rd a
Taylorsville, NC 28681-8414
Phone (828) 732-5300

5045 Hickory Blvd
Hickory, NC 28601-8920
Phone (828) 732-5780

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
101975NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Catawba Valley Medical Group Inc CurrentSince Dec 10, 2018 Accepting new patients
Catawba Valley Medical Group Inc CurrentSince Dec 10, 2018 Accepting new patients
Foothills Internal Medicine Physician Assistant Past Accepting new patients

Locations

200 Rosenwald School St
Catawba, NC 28609
Phone (828) 241-2377

5045 Hickory Blvd
Hickory, NC 28601
Phone (828) 212-1020

810 Fairgrove Church Rd
Hickory, NC 28602
Phone (704) 326-3000

50 Macedonia Church Rd
#A
Taylorsville, NC 28681
Phone (828) 732-5300

Interoperability endpoints

  • Direct secure messaging: bradford.lawrence@cvmg.eclinicaldirectplus.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1376505651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 509",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "287790509",
            "telephone_number": "828-339-7268",
            "fax_number": "828-586-8209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5045 HICKORY BLVD",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286018920",
            "telephone_number": "828-212-1020",
            "fax_number": "828-212-1024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "BRADFORD",
        "middle_name": "W",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "101975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "155KE",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.