Theodore George Brna Jr., M.D.
Individual provider Active NPI Family Medicine Physician · Bailey, NC
NPI 1477547016 · NPPES record last updated May 8, 2008
Key facts
- NPI
- 1477547016
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 38590 (NC)
- Practice address
- 6321 Deans St
Bailey, NC 27807-8641 - Phone
- (252) 235-4181
- Fax
- (252) 235-2950
- NPI assigned
- Sep 9, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050426000611 | NC | Practitioner - Family Practice | 8325086952 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38590 | NC | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 38590 | NC | Yes |
Addresses
Primary practice location
6321 Deans St
Bailey, NC 27807-8641
Mailing address
6321 Deans St
P. O. Box 280
Bailey, NC 27807-8641
Phone (252) 235-4181
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0159H | Other | NC | BLUE CROSS BLUE SHEILD OF NC |
| 7918535 | Medicaid | NC | |
| 080032784 | Other | NC | RAILROAD MEDICARE |
Other providers in Bailey, NC
- Bowden Enterprise Services, LLC
- Bowden Enterprise Services, LLC
- Bowden Enterprise Services, LLC
- Bowden Enterprise Services, LLC
- Tiffany C. L. Bowden
- Sonya Simmons Bullock
- Cornerstone Community Support Services, Inc.
- Kelly P Day
- Divinity Healthcare Services, Inc
- DLP Wilson Physician Practices LLC
All providers in Bailey, NC · Family Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 8, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.