Active NPI
Bridget Blais Florack, MD
- Anesthesiology Physician
- Clemmons, NC
National Provider Identifier
1780951905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 94-00490
- Practice address
- 3546 Tanglebrook TRL
Clemmons, NC 27012-8502 - Phone
- (336) 413-3120
- Fax
- (336) 201-2530
- NPI assigned
- Nov 17, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 94-00490 | NC | Primary |
Addresses
Primary practice location
3546 Tanglebrook TRL
Clemmons, NC 27012-8502
Mailing address
3546 Tanglebrook TRL
Clemmons, NC 27012-8502
Phone (336) 413-3120
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 94-00490 | NC | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri-County Anesthesia and Pain Management PA | Anesthesiology | Past | Accepting new patients |
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.
-
- Anesthesiology Physician
- Edenton, NC
- NPI 1275503195
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321488000000",
"number": "1780951905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3546 TANGLEBROOK TRL",
"city": "CLEMMONS",
"state": "NC",
"postal_code": "270128502",
"telephone_number": "336-413-3120",
"fax_number": "336-201-2530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3546 TANGLEBROOK TRL",
"city": "CLEMMONS",
"state": "NC",
"postal_code": "270128502",
"telephone_number": "336-413-3120",
"fax_number": "336-201-2530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLORACK",
"first_name": "BRIDGET",
"middle_name": "BLAIS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-17",
"last_updated": "2011-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NC",
"license": "94-00490",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clemmons, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.