Daniel Justin Bryan-Ledwell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-02688 Issued in NC

Practice address

900 Old Winston Rd
Suite 116
Kernersville, NC 27284-9965

Phone

(336) 992-0491

Fax

(336) 450-1722

NPI assigned

Dec 29, 2010

Last updated

Nov 7, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Daniel Justin Bryan Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2019 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Bryan Medical and Wellness PLLC

  • Family Medicine Physician
  • Kernersville, NC
  • NPI 1255179362
  NPD
• Cornerstone Health Care, PA

  dba Laurel Creek Family Medicine, a Cornerstone Practice

  • Family Medicine Physician
  • Kernersville, NC
  • NPI 1558613901
  NPD (past)
• Laurel Creek Family Medicine, PLLC

  • Family Medicine Physician
  • Kernersville, NC
  • NPI 1487867347
  NPD (past)

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

{
    "created_epoch": "1293580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1710281035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 OLD WINSTON RD",
            "address_2": "SUITE 116",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272849965",
            "telephone_number": "336-992-0491",
            "fax_number": "336-450-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 OLD WINSTON RD",
            "address_2": "SUITE 116",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272849965",
            "telephone_number": "336-992-0491",
            "fax_number": "336-450-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN-LEDWELL",
        "first_name": "DANIEL",
        "middle_name": "JUSTIN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-29",
        "last_updated": "2024-11-07",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-02688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8102835",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIEL",
            "last_name": "BRYAN",
            "middle_name": "JUSTIN",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Timothy Brown
• Tami Jo Bruggeman, MSN, APRN, FNP-BC
• Christopher Scott Brumfield, MD
• Anne Elizabeth Brush, PT, DPT
• Bryan Medical and Wellness PLLC
• Dmyia Bryant
• Brittni Bullins
• Candice Bullock
• Lindsay Marie Burch
• Sarah Burch, RD, LDN

• Physician Assistant in Kernersville, NC
• Providers in Kernersville, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.