NPIMap

Individual provider Active NPI

Chacey Bryan, M.D.

  • General Practice Physician
  • Wilmington, NC
National Provider Identifier
1699228734
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
87072 Issued in SC
Practice address
3205 Randall Pkwy Ste 105
Wilmington, NC 28403-2565
Phone
(910) 742-9243
NPI assigned
Jul 25, 2016
Last updated
Oct 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 87072 SC
General Practice Physician 208D00000X 296938-1 NY
General Practice Physician 208D00000X 87072 SC Primary
General Practice Physician 208D00000X 2024-01387 NC

Addresses

Primary practice location

3205 Randall Pkwy Ste 105
Wilmington, NC 28403-2565

Mailing address

105 Franklin Square Way Ste a
Easley, SC 29642-3715
Phone (864) 442-4110

Other practice location 1

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 299-7295

Other practice location 2

1329 SW 16th ST
Suite 5270
Gainesville, FL 32620-0186
Phone (352) 265-5911

Other practice location 3

1329 SW 16th ST
Suite 5270
Gainesville, FL 32620-0186
Phone (352) 265-5911

Other practice location 4

105 Franklin Square Way Ste A
Easley, SC 29642-3715
Phone (864) 442-4110 ext. 729

Other practice location 5

939 Springdale Dr
Clinton, SC 29325-7266
Phone (910) 742-9243

Other identifiers 1

IdentifierTypeStateIssuer
870720MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cbryan@ohw-sc.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220404001270 SC Practitioner - Family Practice 9234425885 Reassigns benefits to 6 organizations
I20241009002580 NC Practitioner - General Practice 9234425885 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Florida College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Onsite Healthcare and Wellness LLCGroup PAC ID 6800141631, 28 clinicians
Lifesource of North CarolinaGroup PAC ID 7416132428, shared by 9 NPIs, 172 clinicians
Lifesource Prime IncGroup PAC ID 7810336385, shared by 3 NPIs, 52 clinicians

Practice addresses (Care Compare)

105 Franklin Square Way
Suite a
Easley, SC 29642-3715
Phone (864) 442-4110

3205 Randall Pkwy
Suite 105
Wilmington, NC 28403-2565
Phone (910) 742-9243

939 Springdale Dr
Clinton, SC 29325-7266
Phone (910) 742-9243

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
296938-1NYMDGeneral Practice Physician
87072SCMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Weekend Medical Solutions SC LLC Family Medicine CurrentSince Dec 24, 2025 Accepting new patients
Onsite Medical Solutions SC Coastal LLC Family Medicine CurrentSince Oct 23, 2024 Accepting new patients
Onsite Healthcare and Wellness LLC Family Medicine CurrentSince May 11, 2022 Accepting new patients
Onsite Medical Solutions SC Upstate LLC Family Medicine CurrentSince Nov 5, 2024 Accepting new patients
Lifesource Prime Inc Family Medicine CurrentSince Jul 1, 2024 Accepting new patients
Lifesource Prime Inc Family Medicine CurrentSince Sep 10, 2024 Accepting new patients
Lifesource of North Carolina CurrentSince Sep 13, 2023 Accepting new patients
Lifesource of North Carolina Family Medicine CurrentSince Jul 29, 2024 Accepting new patients
Lifesource Prime Inc Family Medicine CurrentSince Jul 1, 2024 Accepting new patients
Lifesource of North Carolina Family Medicine CurrentSince Sep 13, 2023 Accepting new patients
Hudson View Care Center Inc. Past Accepting new patients

Locations

3205 Randall Pkwy
Ste 105
Wilmington, NC 28403
Phone (910) 338-2880

105 Franklin Square Way
#A
Easley, SC 29642
Phone (864) 442-4019

1915 Ebenezer Rd
Rock Hill, SC 29732
Phone (305) 866-9951

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Greenville Post AcuteGreenville, SC, CCN 425042 Skilled nursing facility Operational/Managerial Control Feb 1, 2023
Brushy Creek Post AcuteGreer, SC, CCN 425004 Skilled nursing facility Contracted Managing Employee Feb 1, 2024
Chandler Creek Post AcuteGreer, SC, CCN 425138 Skilled nursing facility Contracted Managing Employee Feb 1, 2024

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 52

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

View all 52

NPI Registry JSON

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

{
    "created_epoch": "1469404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1699228734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 FRANKLIN SQUARE WAY STE A",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296423715",
            "telephone_number": "864-442-4110",
            "fax_number": "864-442-4126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 RANDALL PKWY STE 105",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032565",
            "telephone_number": "910-742-9243"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2015 Grand Concourse",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "10453",
            "country_code": "US",
            "telephone_number": "718-299-7295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1329 SW 16th ST",
            "address_2": "Suite 5270",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326200186",
            "country_code": "US",
            "telephone_number": "352-265-5911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1329 SW 16th ST",
            "address_2": "Suite 5270",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326200186",
            "country_code": "US",
            "telephone_number": "352-265-5911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 Franklin Square Way Ste A",
            "address_purpose": "LOCATION",
            "city": "Easley",
            "state": "SC",
            "postal_code": "296423715",
            "country_code": "US",
            "telephone_number": "864-442-4110 x729",
            "fax_number": "864-442-4126",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "939 Springdale Dr",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "SC",
            "postal_code": "293257266",
            "country_code": "US",
            "telephone_number": "910-742-9243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "CHACEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-25",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "87072",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "296938-1",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "SC",
            "license": "87072",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NC",
            "license": "2024-01387",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "870720",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cbryan@ohw-sc.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "105 Franklin Square Way Ste A",
            "city": "Easley",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296423715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.