N.C. Kidney Care, P.a.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

N.C. KIDNEY CARE, P.A.

Practice address

2605 Forest Hills Rd SW Ste a
Wilson, NC 27893-4448

Phone

(252) 293-9898

Fax

(252) 293-9915

NPI assigned

May 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Robert William Bynum IV, M.D.NPI 1477525111

Title

Physician

Phone

(252) 293-9898

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 3

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.

• Robert William Bynum IV, MD

  • Nephrology Physician
  • Wilson, NC
  • NPI 1477525111
  Medicare reassignment Care Compare group NPD Authorized official
• Nirav Manubhai Jasani, MD

  • Nephrology Physician
  • Wilson, NC
  • NPI 1215229612
  Medicare reassignment Care Compare group NPD
• Christy Dawn Kubrock

  • Nurse Practitioner
  • Greenville, NC
  • NPI 1164770699
  Medicare reassignment NPD

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635724800000",
    "number": "1396966412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 FOREST HILLS RD SW STE A",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278934448",
            "telephone_number": "252-293-9898",
            "fax_number": "252-293-9915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 FOREST HILLS RD SW STE A",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278934448",
            "telephone_number": "252-293-9898",
            "fax_number": "252-293-9915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "N.C. KIDNEY CARE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A",
        "authorized_official_last_name": "BYNUM",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "252-293-9898",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890139C",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GOUP NUMBER",
            "identifier": "0139C",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caroline Vaughn Myers
• Myles Home Health Agency
• Myles Home Health Agency II
• Frederick Myles Jr.
• Myles's Services, Inc.
• Nash Street Family Practice , P.C.
• Nash Street Healthcare
• Nash Street Healthcare
• Natalie a. Doyle, M. D., P. a.
• Natalie a. Doyle, MD

• Nephrology Physician in Wilson, NC
• Providers in Wilson, NC by specialty
• Nephrology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.