Individual provider Active NPI

Leslie Jane Bryan, MD

  • Internal Medicine Physician
  • Winston Salem, NC
National Provider Identifier
1770547986
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2008-00030 Issued in NC
Practice address
4692 Brownsboro Rd
Physicians Eldercare
Winston Salem, NC 27106-3410
Phone
(336) 251-1114
Fax
(336) 251-1115
NPI assigned
Apr 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 235609 NY
Internal Medicine Physician 207R00000X 2008-00030 NC Primary

Addresses

Primary practice location

4692 Brownsboro Rd
Physicians Eldercare
Winston Salem, NC 27106-3410

Mailing address

4692 Brownsboro Rd
Physicians Eldercare
Winston Salem, NC 27106-3410
Phone (336) 251-1114

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150119000377 NC Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6507911021

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
235609NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Eldercare PA Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 1

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300752000000",
    "number": "1770547986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4692 BROWNSBORO RD",
            "address_2": "PHYSICIANS ELDERCARE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063410",
            "telephone_number": "336-251-1114",
            "fax_number": "336-251-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4692 BROWNSBORO RD",
            "address_2": "PHYSICIANS ELDERCARE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063410",
            "telephone_number": "336-251-1114",
            "fax_number": "336-251-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "LESLIE",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2011-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "235609",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2008-00030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.