Active NPI
Paulette C Bryant, M.D
- Pediatric Hematology & Oncology Physician
- Charlotte, NC
National Provider Identifier
1649268160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Hematology & Oncology Physician
- License
- 200501171
- Practice address
- 301 Hawthorne LN
Suite 100
Charlotte, NC 28204-2450 - Phone
- (704) 384-1900
- Fax
- (704) 384-1919
- NPI assigned
- Oct 10, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 200501171 | NC | |
| Pediatric Hematology & Oncology Physician | 2080P0207X | 200501171 | NC | Primary |
Addresses
Primary practice location
301 Hawthorne LN
Suite 100
Charlotte, NC 28204-2450
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-1900
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5902306 | Medicaid | NC | |
| N01178 | Medicaid | SC |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pbryant14813@direct.novanthealth.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200501171 | NC | MD | Pediatric Hematology & Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603843200000",
"number": "1649268160",
"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": "704-384-1900",
"fax_number": "704-384-1919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 HAWTHORNE LN",
"address_2": "SUITE 100",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282042450",
"telephone_number": "704-384-1900",
"fax_number": "704-384-1919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRYANT",
"first_name": "PAULETTE",
"middle_name": "C",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-10",
"last_updated": "2020-10-28",
"certification_date": "2020-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "200501171",
"primary": false
},
{
"code": "2080P0207X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Hematology-Oncology",
"state": "NC",
"license": "200501171",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5902306",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "N01178",
"state": "SC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "pbryant14813@direct.novanthealth.org",
"affiliation": "N",
"address_1": "301 Hawthorne Ln",
"address_2": "Suite 100",
"city": "Charlotte",
"state": "NC",
"country_code": "US",
"postal_code": "282042450",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.