Individual provider Active NPI

Lauren Nicole Branham, PA

  • Physician Assistant
  • Concord, NC
National Provider Identifier
1801265244
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-07416 Issued in NC
Practice address
920 Church St N
Concord, NC 28025-2927
Phone
(704) 403-1311
NPI assigned
Sep 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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 0010-07416 NC Primary

Addresses

Primary practice location

920 Church St N
Concord, NC 28025-2927

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 446-4490

Other practice location 2

1550 Faulk St
Monroe, NC 28112-5086
Phone (704) 289-3024

Other practice location 3

200 Medical Park Dr
Ste 430
Concord, NC 28025-2982
Phone (704) 403-7070

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network
Direct Messaging Address lgorman499745@CarolinasHealthcareSystem.direct-ci.com Atrium Health

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161227000150 SC Practitioner - Physician Assistant 1254612674 Reassigns benefits to 1 organization
I20171023001126 NC Practitioner - Physician Assistant 1254612674 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Medical CenterGroup PAC ID 4789597477, 1,057 clinicians
The Charlotte-Mecklenburg Hospital AuthorityGroup PAC ID 2961310685, 594 clinicians

Practice addresses (Care Compare)

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 355-2000

1090 NE Gateway CT NE
Concord, NC 28025-2927
Phone (704) 403-1311

200 Medical Park Dr
Concord, NC 28025-0933

920 Church N St
Concord, NC 28025-2927
Phone (704) 403-3000

920 Church St N
Concord, NC 28025-2927
Phone (704) 403-3000

Hospital & facility affiliations

  • Carolinas Medical Center-Northeast Hospital, Concord, NC, CCN 340001

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-07416NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center CurrentSince Aug 21, 2017 Accepting new patients
Carolinas Medical Center CurrentSince Aug 21, 2017 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Dec 16, 2016 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Jul 8, 2019 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Jul 8, 2019 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Dec 16, 2016 Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

1025 Morehead Medical Dr
Ste 200
Charlotte, NC 28204
Phone (704) 302-8000

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

920 Church St N
Concord, NC 28025
Phone (704) 403-3000

1085 NE Gateway Ct NE
#200A
Concord, NC 28025
Phone (704) 403-8650

920 Church St N
Ste 255
Concord, NC 28025
Phone (704) 403-1331

200 Medical Park Dr
Ste 430
Concord, NC 28025
Phone (704) 403-5890

200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740

1550 Faulk St
Monroe, NC 28112
Phone (980) 442-0430

9 Richland Medical Park Dr
Ste 450
Columbia, SC 29203
Phone (803) 434-8800

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

Interoperability endpoints

  • Direct secure messaging: lgorman499745@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 9

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1801265244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 CHURCH ST N",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252927",
            "telephone_number": "704-403-1311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 S Kings Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282072134",
            "country_code": "US",
            "telephone_number": "704-446-4490",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1550 Faulk St",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "NC",
            "postal_code": "281125086",
            "country_code": "US",
            "telephone_number": "704-289-3024",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Medical Park Dr",
            "address_2": "Ste 430",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252982",
            "country_code": "US",
            "telephone_number": "704-403-7070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANHAM",
        "first_name": "LAUREN",
        "middle_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-16",
        "last_updated": "2024-07-15",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lgorman499745@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "920 Church St N",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280252927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.