NPIMap

Individual provider Active NPI

Thomas Radford Brown Jr., PA-C

  • Physician Assistant
  • Fayetteville, NC
National Provider Identifier
1376965988
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001004696 Issued in NC
Practice address
1839 Quiet CV
Fayetteville, NC 28304-3857
Phone
(910) 323-1463
Fax
(910) 323-1575
NPI assigned
Jan 16, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X 001004696 NC Primary

Addresses

Primary practice location

1839 Quiet CV
Fayetteville, NC 28304-3857

Mailing address

1839 Quiet CV
Fayetteville, NC 28304-3857
Phone (910) 323-1463

Other identifiers 2

IdentifierTypeStateIssuer
NC1621AOtherNCMEDICARE
1376965988MedicaidNC

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
I20140722000748 NC Practitioner - Physician Assistant 7012133473 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fayetteville Otolaryngology Head and Neck Surgery P.a.Group PAC ID 2163421520, 7 clinicians
MCPC-28, LLCGroup PAC ID 2163929175, 8 clinicians

Practice addresses (Care Compare)

1839 Quiet CV
Fayetteville, NC 28304-3857
Phone (910) 323-1463

Hospital & facility affiliations

  • Firsthealth Moore Regional Hospital Hospital, Pinehurst, NC, CCN 340115
  • Cape Fear Valley Medical Center Hospital, Fayetteville, NC, CCN 340028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001004696NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MCPC-28, LLC Single Specialty CurrentSince Oct 1, 2025 Accepting new patients
Fayetteville Plastic Surgery Specialists, PA Single Specialty Past Accepting new patients

Locations

1839 Quiet Cv
Fayetteville, NC 28304
Phone (910) 323-1463

Interoperability endpoints

  • Direct secure messaging: tbrown128952@firsthealth.direct-ci.net
  • Direct secure messaging: thomasbrown@fo.allscriptsdirect.net

Organizations & group practices 3

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.

Hospital & facility affiliations 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1389830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1376965988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 QUIET CV",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043857",
            "telephone_number": "910-323-1463",
            "fax_number": "910-323-1575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1839 QUIET CV",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043857",
            "telephone_number": "910-323-1463",
            "fax_number": "910-323-1575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "THOMAS",
        "middle_name": "RADFORD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-16",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001004696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "NC1621A",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376965988",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.