Individual provider Active NPI

Brandi Eberly Wymer, PA-C

  • Physician Assistant
  • Gulf Shores, AL
National Provider Identifier
1437583127
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
918 Issued in AL
Practice address
156 E 15TH Ave
Gulf Shores, AL 36542-3516
Phone
(251) 948-4290
Fax
(251) 948-7682
NPI assigned
Aug 29, 2013
Last updated
Oct 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 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 Assistant 363A00000X 918 AL Primary

Addresses

Primary practice location

156 E 15TH Ave
Gulf Shores, AL 36542-3516

Mailing address

156 E 15TH Ave
Gulf Shores, AL 36542-3516
Phone (251) 948-4290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20131016001277 AL Practitioner - Physician Assistant 2961636428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Alabama School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jeanne M Birkenhauer, M.D., P.C.Group PAC ID 9537220397, 7 clinicians

Practice addresses (Care Compare)

156 E 15TH Ave
Suite 1
Gulf Shores, AL 36542-3517
Phone (251) 948-4290

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
918ALMDPhysician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1377734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1437583127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 E 15TH AVE",
            "city": "GULF SHORES",
            "state": "AL",
            "postal_code": "365423516",
            "telephone_number": "251-948-4290",
            "fax_number": "251-968-1817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 E 15TH AVE",
            "city": "GULF SHORES",
            "state": "AL",
            "postal_code": "365423516",
            "telephone_number": "251-948-4290",
            "fax_number": "251-948-7682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYMER",
        "first_name": "BRANDI",
        "middle_name": "EBERLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-29",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulf Shores, AL

Sources for this page

Verify at the official NPI Registry.