Individual provider Active NPI

Micah Bright

  • Psychiatric/Mental Health Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1669193330
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5016681 Issued in NC
Practice address
10420 Park Rd Ste 300
Charlotte, NC 28210-8502
Phone
(980) 237-4766
NPI assigned
Sep 9, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X BRIG-W6L40 NC
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5016681 NC Primary

Addresses

Primary practice location

10420 Park Rd Ste 300
Charlotte, NC 28210-8502

Mailing address

10420 Park Rd Ste 300
Charlotte, NC 28210-8502
Phone (980) 237-4766

Other practice location 1

8430 Medical Plaza Dr
Charlotte, NC 28262-9747
Phone (704) 910-6142

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
I20230406002226 NC Practitioner - Nurse Practitioner 7012382930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10420 Park Rd
Suite 300
Charlotte, NC 28210-8502
Phone (980) 237-4766

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
BRIG-W6L40NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric and Family Behavioral Health Acquisition Group PLLC Psychiatric/Mental Health CurrentSince Jan 23, 2023 Accepting new patients

Locations

10440 Park Rd
Ste 300
Charlotte, NC 28210
Phone (980) 237-4766

10420 Park Rd
Ste 300
Charlotte, NC 28210
Phone (980) 237-4766

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1662681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1669193330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10420 PARK RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108502",
            "telephone_number": "980-237-4766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10420 PARK RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108502",
            "telephone_number": "980-237-4766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8430 Medical Plaza Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282629747",
            "country_code": "US",
            "telephone_number": "704-910-6142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRIGHT",
        "first_name": "MICAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-09",
        "last_updated": "2023-07-10",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "BRIG-W6L40",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5016681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.