Organization Active NPI

Braincare, LLC

  • Neurology Physician
  • Charlotte, NC
National Provider Identifier
1457725889
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
BRAINCARE, LLC
Practice address
401 N Tryon St
Ste 1120
Charlotte, NC 28202-2196
Phone
(866) 848-2522
Fax
(877) 290-1544
NPI assigned
Nov 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2016

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

Authorized official

Name
Janice Shock, R.EEGT
Title
Sr Director of Operations
Phone
(214) 532-3757

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X Primary
Physiological Laboratory 293D00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X

Addresses

Primary practice location

401 N Tryon St
Ste 1120
Charlotte, NC 28202-2196

Mailing address

2670 Firewheel Dr
Ste B
Flower Mound, TX 75028-4601
Phone (866) 848-2522

Other names 1

  • Global Neuro-Diagnostics Doing business as

National Provider Directory

National Provider Directory

Locations

401 N Tryon St
Charlotte, NC 28202
Phone (888) 603-2536

NPI Registry JSON

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

{
    "created_epoch": "1448236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480550400000",
    "number": "1457725889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2670 FIREWHEEL DR",
            "address_2": "STE B",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750284601",
            "telephone_number": "866-848-2522",
            "fax_number": "877-290-1544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N TRYON ST",
            "address_2": "STE 1120",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022196",
            "telephone_number": "866-848-2522",
            "fax_number": "877-290-1544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAINCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-23",
        "last_updated": "2016-12-01",
        "status": "A",
        "authorized_official_last_name": "SHOCK",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "SR DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "214-532-3757",
        "authorized_official_credential": "R.EEGT"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Global Neuro-Diagnostics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.