Individual provider Active NPI

Brandon Shane Tolbert

  • Physician Assistant
  • Rutherford College, NC
National Provider Identifier
1740846971
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
841 Malcolm Blvd
Rutherford College, NC 28671
Phone
(828) 874-3379
NPI assigned
May 13, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

841 Malcolm Blvd
Rutherford College, NC 28671

Mailing address

841 Malcolm Blvd
Rutherford College, NC 28671

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190828000548 NC Practitioner - Physician Assistant 5395073480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proactive Therapy of North Carolina IncGroup PAC ID 6305753120, shared by 5 NPIs, 540 clinicians
Emergeortho PAGroup PAC ID 0749188894, 726 clinicians

Practice addresses (Care Compare)

20 W Medical CT
Marion, NC 28752-4968
Phone (828) 659-8049

232 Sharon Ave NW
Lenoir, NC 28645-4326
Phone (828) 758-7091

503 E Parker Rd
Morganton, NC 28655-5104
Phone (828) 437-6500

799 Doctors CT
Roxboro, NC 27573-4571
Phone (336) 599-4079

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.07 of 100Reported as group
Quality
85.94
Promoting interoperability
100
Improvement activities
40
Cost
77.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergeortho PA Physician Assistant CurrentSince Jun 17, 2019 Accepting new patients
Emergeortho PA CurrentSince Jun 17, 2019 Accepting new patients

Locations

799 Doctors Ct
Roxboro, NC 27573
Phone (336) 599-4079

Interoperability endpoints

  • Direct secure messaging: brandon.tolbert.1@847.direct.athenahealth.com

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1740846971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 MALCOLM BLVD",
            "city": "RUTHERFORD COLLEGE",
            "state": "NC",
            "postal_code": "28671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 MALCOLM BLVD",
            "city": "RUTHERFORD COLLEGE",
            "state": "NC",
            "postal_code": "28671",
            "telephone_number": "828-874-3379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLBERT",
        "first_name": "BRANDON",
        "middle_name": "SHANE",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-13",
        "last_updated": "2022-05-25",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutherford College, NC

Sources for this page

Verify at the official NPI Registry.