Individual provider Active NPI

Pamela Bowden Brisson, MPT

  • Physical Therapist
  • Raleigh, NC
National Provider Identifier
1427348101
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9845 Issued in NC
Practice address
11200 Governor Manly Way Ste 305
Raleigh, NC 27614-7383
Phone
(919) 562-9410
Fax
(919) 562-2948
NPI assigned
Apr 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 9845 NC Primary

Addresses

Primary practice location

11200 Governor Manly Way Ste 305
Raleigh, NC 27614-7383

Mailing address

PO Box 1107
Wake Forest, NC 27588-1107
Phone (919) 562-9410

Other practice location 1

6602 Knightdale Blvd Ste 310
Knightdale, NC 27545-6526
Phone (919) 562-9410

Other names 1

  • Pamela Lynn Bowden Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110429000400 NC Practitioner - Physical Therapist in Private Practice 9234314568 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duke University Health System, IncGroup PAC ID 2567372345, 1,083 clinicians

Practice addresses (Care Compare)

162 Legacy Oaks Dr
Knightdale, NC 27545-6556
Phone (919) 684-8111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9845NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Activcare Physical Therapy, LLC Physical Therapist CurrentSince Sep 1, 2020 Accepting new patients
Duke University Health System, Inc. Physical Therapist CurrentSince Aug 1, 2022 Accepting new patients
Duke University Health System, Inc. CurrentSince Aug 1, 2022 Accepting new patients
Sports & More Physical Therapy, Inc. Physical Therapist PastSince Oct 24, 2021 Accepting new patients
Duke University Health System, Inc. Past Accepting new patients

Locations

166 Springbrook Ave
Ste 201
Clayton, NC 27520
Phone (919) 535-8461

2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289

3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186

162 Legacy Oaks Dr
Ste 2102
Knightdale, NC 27545
Phone (919) 373-1799

162 Legacy Oaks Dr
Knightdale, NC 27545
Phone (919) 373-1800

3410 Executive Dr
Ste 205
Raleigh, NC 27609
Phone (919) 322-0042

3708 Forestview Rd
Ste 101
Raleigh, NC 27612
Phone (919) 786-7434

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1302739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1427348101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1107",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275881107",
            "telephone_number": "919-562-9410",
            "fax_number": "919-562-2948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 GOVERNOR MANLY WAY STE 305",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276147383",
            "telephone_number": "919-562-9410",
            "fax_number": "919-562-2948"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6602 Knightdale Blvd Ste 310",
            "address_purpose": "LOCATION",
            "city": "Knightdale",
            "state": "NC",
            "postal_code": "275456526",
            "country_code": "US",
            "telephone_number": "919-562-9410",
            "fax_number": "919-562-2948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRISSON",
        "first_name": "PAMELA",
        "middle_name": "BOWDEN",
        "name_prefix": "Mrs.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "9845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "BOWDEN",
            "middle_name": "LYNN",
            "credential": "MPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.