NPIMap

Individual provider Active NPI

Brandon Lee Craven, M.D.

  • Urology Physician
  • Winston Salem, NC
National Provider Identifier
1639342835
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
2012-01321 Issued in NC
Practice address
2010 Baldwin LN
Winston Salem, NC 27103-5846
Phone
(336) 277-1717
Fax
(336) 277-1718
NPI assigned
Apr 8, 2008
Last updated
Aug 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 2012-01321 NC Primary

Addresses

Primary practice location

2010 Baldwin LN
Winston Salem, NC 27103-5846

Mailing address

PO Box 751803
Charlotte, NC 28275-1803
Phone (336) 277-1717

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bcraven77568@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
I20131104001633 NC Practitioner - Urology 3274768908 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients
Forsyth Memorial Hospital, Inc. Urology CurrentSince Aug 15, 2013 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Nov 28, 2016 Accepting new patients
Piedmont Stone Center PLLC Urology CurrentSince Oct 20, 2013 Accepting new patients
Novant Medical Group Inc CurrentSince Nov 28, 2016 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Aug 15, 2013 Accepting new patients
Forsyth Memorial Hospital, Inc Past Accepting new patients
Novant Health Medical Group, LLC Urology PastSince Feb 1, 2022 Accepting new patients

Locations

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

7210 Village Medical Cir
Ste 225
Clemmons, NC 27012
Phone (336) 245-2100

1730 Kernersville Medical Pkwy
Ste 303
Kernersville, NC 27284
Phone (336) 564-4430

291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181

140 Kimel Park Dr
Ste 100
Winston Salem, NC 27103
Phone (336) 245-2100

1907 S Hawthorne Rd
Winston Salem, NC 27103

2010 Baldwin Ln
Winston Salem, NC 27103
Phone (336) 277-1717

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1639342835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "336-277-1717",
            "fax_number": "336-277-1718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 BALDWIN LN",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035846",
            "telephone_number": "336-277-1717",
            "fax_number": "336-277-1718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAVEN",
        "first_name": "BRANDON",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-08",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "2012-01321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bcraven77568@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "2010 Baldwin Ln",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271035846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.