Breanna Elizabeth Flaccavento, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-10537 Issued in NC

Practice address

725 Boyette Road
Four Oaks, NC 27524

Phone

(877) 935-5255

NPI assigned

Mar 31, 2020

Last updated

May 19, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tri County Community Health Council IncGroup PAC ID 2163409558, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Johnston Health Hospital, Smithfield, NC, CCN 340090

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: breannabrabender@tpwhpa.allscriptsdirect.net

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.

• Tri County Community Health Council Inc

  • Federally Qualified Health Center (FQHC)
  • Four Oaks, NC
  • NPI 1427087709
  Medicare reassignment Care Compare group
• Tri County Community Health Council Inc

  dba CommWell Health of Shallotte

  • Federally Qualified Health Center (FQHC)
  • Shallotte, NC
  • NPI 1003218439
  NPD
• Tri County Community Health Council Inc

  dba CommWell Health

  • Adult Mental Health Clinic/Center
  • Dunn, NC
  • NPI 1790270999
  NPD
• Triangle Premier Women's Health, P.a.

  • Obstetrics & Gynecology Physician
  • Smithfield, NC
  • NPI 1457398380
  NPD
• Tri County Community Health Council Inc

  dba CommWell Health - DME

  • Federally Qualified Health Center (FQHC)
  • Dunn, NC
  • NPI 1407025125
  NPD (past)

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

• Johnston Health Services Corporation

  dba Johnston Health

  • General Acute Care Hospital
  • Smithfield, NC
  • NPI 1619911104
  Care Compare affiliation

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1780212175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6114 US HIGHWAY 301 S",
            "city": "FOUR OAKS",
            "state": "NC",
            "postal_code": "275247417",
            "telephone_number": "814-460-4746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 BOYETTE ROAD",
            "city": "FOUR OAKS",
            "state": "NC",
            "postal_code": "27524",
            "telephone_number": "877-935-5255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4350 US 421 S",
            "address_purpose": "LOCATION",
            "city": "Lillington",
            "state": "NC",
            "postal_code": "275466760",
            "country_code": "US",
            "telephone_number": "910-893-1210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLACCAVENTO",
        "first_name": "BREANNA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-31",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-10537",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Children Under Construction Treatment Center, Barnes Inc.
• Counseling Connections, PLLC
• Diversified Staffing Service
• Carl Gene Edwards Jr., PHARMD
• Quinton Edwards, PA-C
• Joyce Lynn Fountain, RRT
• Four Oaks Assisted Living
• Four Oaks Opco Holdings, LLC (Oak View Commons)
• Four Oaks Rescue Squad
• Ashley Nicole Gaussa, LPC

• Physician Assistant in Four Oaks, NC
• Providers in Four Oaks, 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 May 19, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.