Individual provider Active NPI

Bryan Terence Edwards, PA-C

  • Physician Assistant
  • Clayton, NC
National Provider Identifier
1649829557
Registry record updated Feb 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001009407 Issued in NC
Practice address
34 Healthpark Way Ste 100
Clayton, NC 27520-4497
Phone
(919) 585-8850
Fax
(919) 585-8869
NPI assigned
Sep 4, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001009407 NC Primary

Addresses

Primary practice location

34 Healthpark Way Ste 100
Clayton, NC 27520-4497

Mailing address

2000 Perimeter Park Dr Ste 200
Morrisville, NC 27560-8442

Other practice location 1

6602 Knightdale Blvd Ste 102
Knightdale, NC 27545-6526
Phone (919) 747-5210

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address bedwards183213@direct.UNC.nchie.net Direct
Direct Messaging Address bedwards183213@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200106001680 NC Practitioner - Physician Assistant 9638503303 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Carolina MG LLCGroup PAC ID 1951828847, 723 clinicians
Unc Physicians Network LLCGroup PAC ID 5496940546, 985 clinicians

Practice addresses (Care Compare)

1059 Beaver Creek Commons Dr
Unit 230
Apex, NC 27502-3918
Phone (984) 960-1300

1104 Market Ctr Dr
Suite 130
Morrisville, NC 27560-7504
Phone (984) 960-1200

11200 Governor Manly Way
Raleigh, NC 27614-7360

1165 US Hwy 70 W
Garner, NC 27529-2547
Phone (984) 960-1400

1617 N Main St
Fuquay Varina, NC 27526-9021

3050 Duraleigh Rd
Raleigh, NC 27612-5451

34 Healthpark Way
Clayton, NC 27520-4497
Phone (919) 585-8850

37 Pineville Blvd
Clayton, NC 27527-9355

4420 Lake Boone TRL
Raleigh, NC 27607-7505

51 Mosaic Blvd
Pittsboro, NC 27312-4945

6013 Farrington Rd
Suite 101
Chapel Hill, NC 27517-8173
Phone (919) 957-6610

6602 Knightdale Blvd
Knightdale, NC 27545-6526

6701B NC Hwy 135
Mayodan, NC 27027-8487
Phone (336) 635-6816

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514-2601
Phone (919) 942-5123

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Arts, Physician Assistant

State licenses

LicenseStateTypeSpecialty
001009407NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Unc Physicians Network LLC CurrentSince Nov 13, 2019 Accepting new patients
Unc Physicians Network LLC CurrentSince Nov 13, 2019 Accepting new patients
Rex Hospital Inc Past Accepting new patients

Locations

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-5123

37 Pineville Blvd
#102
Clayton, NC 27527
Phone (919) 346-8680

34 Healthpark Way
Ste 100
Clayton, NC 27520
Phone (919) 585-8850

2000 Perimeter Park Dr
Ste 200
Morrisville, NC 27560
Phone (800) 594-8624

2605 Blue Ridge Rd
Ste 300
Raleigh, NC 27607
Phone (919) 782-0146

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

4551 New Bern Ave
Ste 100
Raleigh, NC 27610
Phone (984) 215-4950

514 N Brightleaf Blvd
Ste 1610
Smithfield, NC 27577
Phone (919) 934-8171

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1649829557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 PERIMETER PARK DR STE 200",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275608442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 HEALTHPARK WAY STE 100",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275204497",
            "telephone_number": "919-585-8850",
            "fax_number": "919-585-8869"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6602 Knightdale Blvd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Knightdale",
            "state": "NC",
            "postal_code": "275456526",
            "country_code": "US",
            "telephone_number": "919-747-5210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "BRYAN",
        "middle_name": "TERENCE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-04",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001009407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bedwards183213@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "6602 Knightdale Blvd Ste 102",
            "city": "Knightdale",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275456526",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bedwards183213@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "34 Healthpark Way Ste 100",
            "city": "Clayton",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275204497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clayton, NC

Sources for this page

Verify at the official NPI Registry.