Active NPI
Brandon Fraser Wyche, PA-C
- Medical Physician Assistant
- Butner, NC
National Provider Identifier
1659671220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 0010-02562
- Practice address
- Fci Butner Medium II Old NC Hwy 75
Butner, NC 27509 - Phone
- (919) 575-8000
- NPI assigned
- Oct 28, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 0010-02562 | NC | Primary |
Addresses
Primary practice location
Fci Butner Medium II Old NC Hwy 75
Butner, NC 27509
Mailing address
Fci Butner Medium II Old NC Hwy 75
Butner, NC 27509
Phone (919) 575-8000
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-02562 | NC | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472169600000",
"number": "1659671220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "FCI BUTNER MEDIUM II OLD NC HWY 75",
"city": "BUTNER",
"state": "NC",
"postal_code": "27509",
"telephone_number": "919-575-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "FCI BUTNER MEDIUM II OLD NC HWY 75",
"city": "BUTNER",
"state": "NC",
"postal_code": "27509",
"telephone_number": "919-575-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYCHE",
"first_name": "BRANDON",
"middle_name": "FRASER",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-28",
"last_updated": "2016-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NC",
"license": "0010-02562",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Butner, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.