Individual provider Active NPI

Sara Nicole Brame

  • Psychologist
  • Jacksonville, NC
National Provider Identifier
1467179994
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
103503 Issued in NC
Practice address
200 Tarpon TRL
Jacksonville, NC 28546-5287
Phone
(910) 938-1114
Fax
(910) 938-1118
NPI assigned
Oct 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 103503 NC Primary

Addresses

Primary practice location

200 Tarpon TRL
Jacksonville, NC 28546-5287

Mailing address

200 Tarpon TRL
Jacksonville, NC 28546-5287
Phone (910) 938-1114

Other practice location 1

1630 Military Cutoff Rd Ste 108
Wilmington, NC 28403-5719
Phone (910) 938-1114

Other practice location 2

400 Liberty Hill Rd
Lumberton, NC 28358-2446
Phone (910) 938-1114

Other practice location 3

302 Penny Ln
Morehead City, NC 28557-4306
Phone (910) 938-1114

Other practice location 4

1200 Fairmont Ct
Fayetteville, NC 28304-4403
Phone (910) 938-1114

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address credentialing@coastalcarolinapysch.com Direct

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231011003023 NC Practitioner - Clinical Psychologist 6507211521 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
103503NCMDPsychologist
6399NCMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Carolina Neuropsychiatric Center, PA Psychologist CurrentSince Aug 23, 2023 Accepting new patients

Locations

1200 Fairmont Ct
Fayetteville, NC 28304
Phone (910) 429-1114

200 Tarpon Trl
Jacksonville, NC 28546
Phone 9109381114139

400 Liberty Hill Rd
Lumberton, NC 28358
Phone (910) 738-8060

302 Penny Ln
Morehead City, NC 28557
Phone (252) 726-8016

1630 Military Cutoff Rd
Ste 108
Wilmington, NC 28403

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1666656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1467179994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 TARPON TRL",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465287",
            "telephone_number": "910-938-1114",
            "fax_number": "910-938-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 TARPON TRL",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465287",
            "telephone_number": "910-938-1114",
            "fax_number": "910-938-1118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1630 Military Cutoff Rd Ste 108",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284035719",
            "country_code": "US",
            "telephone_number": "910-938-1114",
            "fax_number": "910-938-1118",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Liberty Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Lumberton",
            "state": "NC",
            "postal_code": "283582446",
            "country_code": "US",
            "telephone_number": "910-938-1114",
            "fax_number": "910-938-1118",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "302 Penny Ln",
            "address_purpose": "LOCATION",
            "city": "Morehead City",
            "state": "NC",
            "postal_code": "285574306",
            "country_code": "US",
            "telephone_number": "910-938-1114",
            "fax_number": "910-938-1118",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 Fairmont Ct",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283044403",
            "country_code": "US",
            "telephone_number": "910-938-1114",
            "fax_number": "910-938-1118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAME",
        "first_name": "SARA",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-25",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "103503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@coastalcarolinapysch.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "credentialing@coastalcarolinapysch.com",
            "address_1": "200 Tarpon Trl",
            "city": "Jacksonville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "285465287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.