Brianna Vincent, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-07222 Issued in NC

Practice address

2105 Juniper Lake Rd Ste a
West End, NC 27376-9051

Phone

(910) 684-1588

NPI assigned

Jan 26, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Pinehurst Medical Clinic, Inc.

  • Internal Medicine Physician
  • Pinehurst, NC
  • NPI 1255388369
  NPD (past)
• Pinehurst Medical Clinic, Inc.

  • Clinical Medical Laboratory
  • Southern Pines, NC
  • NPI 1962509372
  NPD (past)

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

{
    "created_epoch": "1422230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1629468913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 SHORT RD",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 JUNIPER LAKE RD STE A",
            "city": "WEST END",
            "state": "NC",
            "postal_code": "273769051",
            "telephone_number": "910-684-1588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "BRIANNA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-26",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "52259",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA PA LICENSE",
            "identifier": "0010-07222",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Lee Tracy, MD
• Transformation Chiropractic PLLC
• Linda Tufts
• Alexandra Luther Underwood
• Erica Vasquez
• Allison Von Zup
• Dorothy Ann Werkmeister, LPC
• West End Holdings, LLC
• Ashley L Williams, M.A., CCC-SLP
• Natasha Williams

• Physician Assistant in West End, NC
• Providers in West End, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.