NPIMap

Organization Active NPI

Brunswick Community Hospital, LLC

Doing business as Novant Health Brunswick Medical Center CRNAS

  • Certified Registered Nurse Anesthetist
  • Bolivia, NC
National Provider Identifier
1669725198
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
BRUNSWICK COMMUNITY HOSPITAL, LLC
Doing business as
Novant Health Brunswick Medical Center CRNAS
Practice address
240 Hospital Dr NE
Bolivia, NC 28422-8346
Phone
(910) 755-8121
NPI assigned
Oct 22, 2012
Last updated
Oct 8, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
BRUNSWICK COMMUNITY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Authorized official

Name
Heather Marie King
Title
President & Coo Nhbmc
Phone
(336) 726-3316

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NC Primary

Addresses

Primary practice location

240 Hospital Dr NE
Bolivia, NC 28422-8346

Mailing address

PO Box 601474
Charlotte, NC 28260-1474
Phone (336) 277-8757

Other names 1

  • Novant Health Brunswick Medical Center CRNAS Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130903000403 NC Part B Supplier - Clinic/Group Practice 9335150895 Receives reassigned benefits from 634 practitioners
Practice locations: Bolivia, NC

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Brunswick Community Hospital LLC3 organizations share this tax ID, including this one
Part of
Brunswick Community Hospital LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

257 Hospital Dr NE
Ste 102
Bolivia, NC 28422
Phone (910) 721-3150

75 Emerson Bay Rd
#100
Carolina Shores, NC 28467
Phone (910) 575-5100

10 Doctors Cir
#A
Supply, NC 28462
Phone (910) 755-1232

Practitioners & affiliated clinicians

Practitioners 637

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 637

NPI Registry JSON

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

{
    "created_epoch": "1350864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728345600000",
    "number": "1669725198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601474",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601474",
            "telephone_number": "336-277-8757",
            "fax_number": "336-718-8916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 HOSPITAL DR NE",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284228346",
            "telephone_number": "910-755-8121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUNSWICK COMMUNITY HOSPITAL, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRUNSWICK COMMUNITY HOSPITAL",
        "enumeration_date": "2012-10-22",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT & COO NHBMC",
        "authorized_official_telephone_number": "336-726-3316"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Brunswick Medical Center CRNAS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bolivia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.