Brandy L Embry, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-02176 Issued in NC

Practice address

794 S Main St Ste B
Kernersville, NC 27284-4074

Phone

(336) 904-2317

Fax

(336) 443-6030

NPI assigned

May 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Brandy L Wallis Former name

Electronic endpoints 1

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, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolina Quickcare Family Practice, PLLCGroup PAC ID 0840682340, 107 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: bembry746648@direct.novanthealth.org

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.

• Carolina Quickcare Family Practice, PLLC

  • Internal Medicine Physician
  • Biscoe, NC
  • NPI 1881360899
  Medicare reassignment Care Compare group
• Dispatchhealth, PC

  • Emergency Medicine Physician
  • Raleigh, NC
  • NPI 1932714284
  Medicare reassignment
• The Carolinas Emergency Group, PLLC

  • Emergency Medicine Physician
  • Dunn, NC
  • NPI 1477508836
  Medicare reassignment
• True North Health Navigation LLC

  • Emergency Medicine Physician
  • Raleigh, NC
  • NPI 1093343501
  NPD (past)
• Emergency Physicians Professional Association LTD

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1114931490
  NPD (past)

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1790736064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601843",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "794 S MAIN ST STE B",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272844074",
            "telephone_number": "336-904-2317",
            "fax_number": "336-443-6030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4220 Apex Hwy Ste 160",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277135295",
            "country_code": "US",
            "telephone_number": "919-897-8784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EMBRY",
        "first_name": "BRANDY",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2020-11-04",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "02176",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "2097",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-02176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bembry746648@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "794 S Main St Ste B",
            "city": "Kernersville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "272844074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BRANDY",
            "last_name": "WALLIS",
            "middle_name": "L",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Breanna Marie Elliott, MSW
• Jennifer Holly Ellis
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• Engage With Me Speech & Language Services, PLLC
• Melandy N English, PHARMD, MPH
• Natalie Brennan Epps, RD
• Douglas Erickson, PHARMD

• Physician Assistant in Kernersville, NC
• Providers in Kernersville, 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 Nov 4, 2020; 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.