Individual provider Active NPI

Stephen L Bright Jr., LAT, ATC

  • Specialist
  • Wilmington, NC
National Provider Identifier
1700847829
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0058 Issued in NC
Practice address
1717 Shipyard Blvd
Suite 320
Wilmington, NC 28403-8019
Phone
(910) 791-0396
NPI assigned
Mar 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0058 NC Primary

Addresses

Primary practice location

1717 Shipyard Blvd
Suite 320
Wilmington, NC 28403-8019

Mailing address

5223 Lone Eagle CT
Wilmington, NC 28409-3993
Phone (910) 612-2214

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

LicenseStateTypeSpecialty
0058NCMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Sports Medicine &Orthopaedic Specialists PA Specialist Past Accepting new patients
Shoreline Physical Therapy, LLC PastSince Aug 1, 2011 Accepting new patients

Organizations & group practices 2

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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700847829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5223 LONE EAGLE CT",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284093993",
            "telephone_number": "910-612-2214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 SHIPYARD BLVD",
            "address_2": "SUITE 320",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284038019",
            "telephone_number": "910-791-0396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIGHT",
        "first_name": "STEPHEN",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "0058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.