Organization Active NPI

Bryan R Neuwirth DDS MD PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Hickory, NC
National Provider Identifier
1578747507
Registry record updated Oct 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
36121 Issued in NC
Legal business name
BRYAN R NEUWIRTH DDS MD PC
Practice address
261 18TH St CR SE
Hickory, NC 28602-1362
Phone
(828) 327-7867
Fax
(828) 327-6299
NPI assigned
Dec 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2010

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

Authorized official

Name
Ms. Rebecca B McKenzie
Title
Office Manager
Phone
(828) 327-7867

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X 36121 NC Primary

Addresses

Primary practice location

261 18TH St CR SE
Hickory, NC 28602-1362

Mailing address

261 18TH St CR SE
Hickory, NC 28602-1362
Phone (828) 327-7867

Other identifiers 1

IdentifierTypeStateIssuer
2339122OtherNCMEDICARE GROUP NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040720001339 NC Part B Supplier - Clinic/Group Practice 8527048776 Receives reassigned benefits from 1 practitioner
Practice locations: Hickory, NC; Morganton, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287532800000",
    "number": "1578747507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 18TH ST CR SE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286021362",
            "telephone_number": "828-327-7867",
            "fax_number": "828-327-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 18TH ST CR SE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286021362",
            "telephone_number": "828-327-7867",
            "fax_number": "828-327-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN R NEUWIRTH DDS MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2010-10-20",
        "status": "A",
        "authorized_official_last_name": "MCKENZIE",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "828-327-7867",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "36121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "2339122",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.