Individual provider Active NPI

Brandon Thomas Searle

  • Medical Physician Assistant
  • Raleigh, NC
National Provider Identifier
1396300554
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
2626 Glenwood Ave
Raleigh, NC 27608-1043
Phone
(305) 466-9988
Fax
(305) 466-9989
NPI assigned
May 3, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

2626 Glenwood Ave
Raleigh, NC 27608-1043

Mailing address

3800 S Ocean Dr Ste 209
Hollywood, FL 33019-2915
Phone (305) 466-9988

Other practice location 1

7665 Chancellor Dr
Colorado Springs, CO 80920-7143
Phone (321) 960-5294

Other practice location 2

969 Cox Rd
Gastonia, NC 28054-3455
Phone (305) 466-9988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200306000837 NC Practitioner - Physician Assistant 2365870268 Reassigns benefits to 1 organization
I20200728003032 SC Practitioner - Physician Assistant 2365870268 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
QSM-Ky, Inc Medical Past Accepting new patients
Rutherford Internal Medicine Associates PA Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1556841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1396300554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 S OCEAN DR STE 209",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330192915",
            "telephone_number": "305-466-9988",
            "fax_number": "305-466-9989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 GLENWOOD AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276081043",
            "telephone_number": "305-466-9988",
            "fax_number": "305-466-9989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7665 Chancellor Dr",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809207143",
            "country_code": "US",
            "telephone_number": "321-960-5294",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "969 Cox Rd",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280543455",
            "country_code": "US",
            "telephone_number": "305-466-9988",
            "fax_number": "305-466-9989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEARLE",
        "first_name": "BRANDON",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-03",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.