NPIMap

Individual provider Active NPI

Brian Robert Hummel, PA-C

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1518522010
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-09127 Issued in NC
Practice address
5815 Blakeney Park Dr Ste 200B
Charlotte, NC 28277-5734
Phone
(704) 316-5080
Fax
(704) 316-5085
NPI assigned
May 9, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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 0010-09127 NC Primary

Addresses

Primary practice location

5815 Blakeney Park Dr Ste 200B
Charlotte, NC 28277-5734

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (844) 266-8268

Other practice location 1

1401 Matthews Township Pkwy Ste 200
Matthews, NC 28105-5403
Phone (704) 384-6901

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bhummel721495@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190729001044 NC Practitioner - Physician Assistant 3476889403 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
NH Digital Health Services LLCGroup PAC ID 9537588934, 37 clinicians
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

2085 Frontis Plaza Blvd
Winston Salem, NC 27103-5614
Phone (336) 277-8770

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

548 White Oaks Dr
Salisbury, NC 28147-8183
Phone (704) 636-0271

5815 Blakeney Park Dr
Suite 200B
Charlotte, NC 28277-5734
Phone (704) 316-5080

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-09127NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
NH Digital Health Services, LLC CurrentSince Jul 12, 2022 Accepting new patients
Novant Health Medical Group, LLC CurrentSince May 30, 2019 Accepting new patients
NH Digital Health Services, LLC CurrentSince Jul 12, 2022 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

2085 Frontis Plaza Blvd
Winston Salem, NC 27103
Phone (336) 277-7226

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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": "1557360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1518522010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "844-266-8268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5815 BLAKENEY PARK DR STE 200B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282775734",
            "telephone_number": "704-316-5080",
            "fax_number": "704-316-5085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 Matthews Township Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Matthews",
            "state": "NC",
            "postal_code": "281055403",
            "country_code": "US",
            "telephone_number": "704-384-6901",
            "fax_number": "704-384-6902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUMMEL",
        "first_name": "BRIAN",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-09",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-09127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bhummel721495@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1401 Matthews Township Pkwy Ste 200",
            "city": "Matthews",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281055403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.