Individual provider Active NPI

Bryon Evan Rubery, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Winston Salem, NC
National Provider Identifier
1447297833
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
200100276 Issued in NC
Practice address
186 Kimel Park Dr
Winston Salem, NC 27103-6946
Phone
(336) 277-2000
Fax
(336) 277-2050
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 200100276 NC
Cardiovascular Disease Physician 207RC0000X 200100276 NC
Clinical Cardiac Electrophysiology Physician 207RC0001X 200100276 NC Primary

Addresses

Primary practice location

186 Kimel Park Dr
Winston Salem, NC 27103-6946

Mailing address

PO Box 751803
Charlotte, NC 28275-1803
Phone (336) 277-2000

Other identifiers 8

IdentifierTypeStateIssuer
1286COtherNCBCBS
190065OtherNCMEDCOST
5905499MedicaidNC
1447297833MedicaidVA
7659265OtherNCAETNA
3810007248MedicaidWV
Q0027NMedicaidSC
41917OtherNCPARTNERS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brubery159016@direct.novanthealth.org

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
I20061103000235 NC Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 9830105600 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, shared by 14 NPIs, 2,413 clinicians
Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians

Practice addresses (Care Compare)

1226 Eastchester Dr
Suite 100
High Point, NC 27265-3116
Phone (336) 481-8540

186 Kimel Park Dr
Winston Salem, NC 27103-6946
Phone (336) 277-2000

Hospital & facility affiliations

  • Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair28

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200100276NCMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Presbyterian Hospital Internal Medicine Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jan 1, 2015 Accepting new patients
Forsyth Memorial Hospital Inc Cardiovascular Disease CurrentSince Jul 1, 2014 Accepting new patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients
Novant Health Ballantyne Medical Center LLC CurrentSince Sep 18, 2023 Accepting new patients
The Presbyterian Hospital Internal Medicine CurrentSince Apr 13, 2023 Accepting new patients
Novant Health Mint Hill Medical Center, LLC CurrentSince Oct 1, 2018 Accepting new patients
Novant Health Thomasville Medical Center, LLC CurrentSince Apr 1, 2019 Accepting new patients
Medical Park Hospital LLC CurrentSince Aug 17, 2019 Accepting new patients
Novant Health Thomasville Medical Center LLC CurrentSince Apr 1, 2019 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Forsyth Memorial Hospital, Inc. Cardiovascular Disease CurrentSince Jul 1, 2014 Accepting new patients
Novant Health Medical Group, LLC Cardiovascular Disease CurrentSince Feb 1, 2021 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Medical Park Hospital LLC CurrentSince Aug 17, 2019 Accepting new patients
The Presbyterian Hospital CurrentSince Apr 13, 2023 Accepting new patients
Forsyth Memorial Hospital Inc CurrentSince Dec 4, 2016 Accepting new patients
Wake Forest University Health Sciences CurrentSince Jul 1, 2006 Accepting new patients
Novant Health Medical Group, LLC Internal Medicine Past Accepting new patients
Baptist Health System, Inc. Internal Medicine PastSince Apr 1, 1996 Accepting new patients

Locations

10905 Providence Rd W
Charlotte, NC 28277
Phone (980) 488-4000

125 Baldwin Ave
Ste 200
Charlotte, NC 28204
Phone (704) 384-5043

8201 Healthcare Loop
Charlotte, NC 28215
Phone (980) 302-1000

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

100 Johnson Ridge Medical Park
Elkin, NC 28621
Phone (336) 245-2100

189 Samaritans Ridge Rd
Elkin, NC 28621
Phone (336) 526-3003

1226 Eastchester Dr
#100
High Point, NC 27265
Phone (336) 481-8540

291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181

207 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-2000

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

186 Kimel Park Dr
Winston Salem, NC 27103
Phone (336) 277-2000

1950 S Hawthorne Rd
Winston Salem, NC 27103
Phone (336) 718-0600

Organizations & group practices 20

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.

View all 20

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1447297833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "336-277-2000",
            "fax_number": "336-277-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 KIMEL PARK DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036946",
            "telephone_number": "336-277-2000",
            "fax_number": "336-277-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBERY",
        "first_name": "BRYON",
        "middle_name": "EVAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2020-10-25",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "200100276",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "200100276",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NC",
            "license": "200100276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1286C",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "190065",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5905499",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447297833",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7659265",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810007248",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q0027N",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS",
            "identifier": "41917",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brubery159016@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "186 Kimel Park Dr",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271036946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.