Brian Leroy Jerby, M.D.

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

00264 Issued in NC

Practice address

1718 E 4TH St
Suite 307
Charlotte, NC 28204-3261

Phone

(704) 333-1259

Fax

(704) 333-0371

NPI assigned

Nov 4, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2025 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Legacy Health PA

  • Health Service Clinic/Center
  • Matthews, NC
  • NPI 1780147108
  NPD (past) Authorized official
• Charlotte Colon & Rectal Surgery Associates PA

  • Colon & Rectal Surgery Physician
  • Charlotte, NC
  • NPI 1831155738
  NPD
• Novant Health Medical Group, LLC

  • Surgery Physician
  • Charlotte, NC
  • NPI 1083959282
  NPD (past)

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481155200000",
    "number": "1609867993",
    "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": "704-333-1259",
            "fax_number": "704-333-0371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 E 4TH ST",
            "address_2": "SUITE 307",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043261",
            "telephone_number": "704-333-1259",
            "fax_number": "704-333-0371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERBY",
        "first_name": "BRIAN",
        "middle_name": "LEROY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2016-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NC",
            "license": "00264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891195P",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chandler Jensen
• Joshua S Jensen, LMFTA
• Linda Michelle Jensen
• Tara Norbut Jensen, OTR/L
• Chelsea Lee Jentsch, DPT
• Vanessa Jereda
• Ana Paula P Jeri
• Bryce Jerin, MD
• Gloria Michelle Jernigan, RPH
• Peter A Jernigan, MD

• Colon & Rectal Surgery Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Colon & Rectal Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.