Individual provider Active NPI

Brian S. Wood, PA-C

  • Physician Assistant
  • Raleigh, NC
National Provider Identifier
1760652374
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-01292 Issued in NC
Practice address
3633 Harden Rd
Suite 102
Raleigh, NC 27607-3369
Phone
(919) 788-8797
Fax
(919) 788-8798
NPI assigned
Mar 11, 2008
Last updated
Jun 18, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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 0010-01292 NC Primary

Addresses

Primary practice location

3633 Harden Rd
Suite 102
Raleigh, NC 27607-3369

Mailing address

3633 Harden Rd
Suite 102
Raleigh, NC 27607-3369
Phone (919) 788-8797

Other identifiers 1

IdentifierTypeStateIssuer
0010-01292OtherNCLICENSE NUMBER

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
I20080429000824 NC Practitioner - Physician Assistant 2365521580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Brody School of Medicine at East Carolina University, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergeortho PAGroup PAC ID 0749188894, 726 clinicians

Practice addresses (Care Compare)

107 E McClanahan St
Oxford, NC 27565-2919
Phone (919) 692-1105

1111 Huffman Mill Rd
Burlington, NC 27215-8862
Phone (336) 584-5544

120 William Penn PLZ
Durham, NC 27704-2150
Phone (919) 220-5255

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

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

State licenses

LicenseStateTypeSpecialty
0010-01292NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergeortho PA Physician Assistant CurrentSince Mar 12, 2008 Accepting new patients
Emergeortho PA CurrentSince Mar 12, 2008 Accepting new patients

Locations

3633 Harden Rd
Ste 102
Raleigh, NC 27607
Phone (919) 788-8797

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

Interoperability endpoints

  • Direct secure messaging: brian.wood.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1760652374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 HARDEN RD",
            "address_2": "SUITE 102",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276073369",
            "telephone_number": "919-788-8797",
            "fax_number": "919-788-8798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 HARDEN RD",
            "address_2": "SUITE 102",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276073369",
            "telephone_number": "919-788-8797",
            "fax_number": "919-788-8798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "BRIAN",
        "middle_name": "S.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-11",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-01292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "0010-01292",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.