Brandie Rose Buckingham, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-04904 Issued in NC

Practice address

2711 Randolph Rd
BLDG 400
Charlotte, NC 28207-2034

Phone

(704) 348-2992

Fax

(704) 971-0035

NPI assigned

Mar 17, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Carolinas Medical CenterGroup PAC ID 4789597477, 1,057 clinicians

Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bbuckingham195289@direct.novanthealth.org
• Direct secure messaging: bbuckingham631406@carolinashealthcaresystem.direct-ci.com

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.

• Carolinas Medical Center

  • Obstetrics & Gynecology Physician
  • Charlotte, NC
  • NPI 1275774333

  NC

  Medicare reassignment Care Compare group
• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492

  NC

  Medicare reassignment Care Compare group
• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1003803032

  NC

  Medicare reassignment Care Compare group
• Carolinas Medical Center

  • Community/Retail Pharmacy
  • Charlotte, NC
  • NPI 1982710554
  Care Compare group NPD
• Metrolina Nephrology Associates, PA

  • Nephrology Physician
  • Charlotte, NC
  • NPI 1083664189

  NC

  Medicare reassignment
• The Charlotte-Mecklenburg Hospital Authority

  • Medical Oncology Physician
  • Indian Land, SC
  • NPI 1669738829

  NC

  Medicare reassignment
• Carolinas Medical Center

  • Psychiatric Hospital Unit
  • Charlotte, NC
  • NPI 1053358945
  Care Compare group
• Carolinas Medical Center

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1295789907
  Care Compare group
• Carolinas Medical Center

  • Child & Adolescent Psychiatry Physician
  • Charlotte, NC
  • NPI 1356689996
  Care Compare group
• Carolinas Medical Center

  • Children's Rehabilitation Hospital
  • Charlotte, NC
  • NPI 1699829887
  Care Compare group
• Carolinas Medical Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Charlotte, NC
  • NPI 1720029705
  Care Compare group
• Novant Health Medical Group, LLC

  • Foot & Ankle Surgery Podiatrist
  • Thomasville, NC
  • NPI 1235715582
  Care Compare group

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

{
    "created_epoch": "1395014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1689090474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 BAXTER ST",
            "address_2": "STE 215",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043053",
            "telephone_number": "704-332-0396",
            "fax_number": "704-971-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 RANDOLPH RD",
            "address_2": "BLDG 400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072034",
            "telephone_number": "704-348-2992",
            "fax_number": "704-971-0035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKINGHAM",
        "first_name": "BRANDIE",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-17",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-04904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1852PA",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689090474",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bbuckingham195289@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "2711 Randolph Rd",
            "address_2": "Bldg 400",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282072034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patrick Robert Buchwald, PA
• Alexandria S Buck
• John Christopher Buck, PT
• Joshua Buck, D.C.
• Rebecca Buck
• Michael John Buckingham, D.C.
• Ashley Buckius, MPH OTD OTR/L
• Sonja R Buckles-Smith, LCMHCS
• Cheryl Buckley, RDN, CDN , MBA , MS
• Elizabeth Atkison Buckley, CD-L

• All providers in Charlotte, NC
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.