Individual provider Active NPI

Lucas Benjamin Brogden, DO

  • Internal Medicine Physician
  • Wilmington, NC
National Provider Identifier
1417585548
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2023-01745 Issued in NC
Practice address
1202 Medical Center Dr
Wilmington, NC 28401-7307
Phone
(910) 341-3421
Fax
(910) 343-3802
NPI assigned
Apr 1, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 261378 NC
Internal Medicine Physician 207R00000X 2023-01745 NC Primary

Addresses

Primary practice location

1202 Medical Center Dr
Wilmington, NC 28401-7307

Mailing address

1202 Medical Center Dr
Wilmington, NC 28401-7307
Phone (910) 341-1540

Other practice location 1

2131 S 17th St
Wilmington, NC 28401-7407
Phone (910) 343-7000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230906000148 NC Practitioner - Internal Medicine 7517380090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of North Carolina at Chapel Hill School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wilmington Health PLLCGroup PAC ID 6103722509, 364 clinicians

Practice addresses (Care Compare)

1202 Medical Ctr Dr
Wilmington, NC 28401-7307
Phone (910) 341-1540

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2023-01745NCMDInternal Medicine Physician
261378NCMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Wilmington Health PLLC CurrentSince Sep 5, 2023 Accepting new patients
Wha Medical Clinic PLLC Current Accepting new patients
Wilmington ASC LLC CurrentSince Sep 5, 2023 Accepting new patients

Locations

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

1202 Medical Center Dr
Wilmington, NC 28401
Phone (910) 617-6705

Interoperability endpoints

  • Direct secure messaging: lucas.brogden.p1@direct.wilmingtonhealth.nextgenshare.com

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 1

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": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1417585548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017307",
            "telephone_number": "910-341-1540",
            "fax_number": "910-431-4048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017307",
            "telephone_number": "910-341-3421",
            "fax_number": "910-343-3802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2131 S 17th St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284017407",
            "country_code": "US",
            "telephone_number": "910-343-7000",
            "fax_number": "910-667-5650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROGDEN",
        "first_name": "LUCAS",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-01",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "261378",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2023-01745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.