Brian Patrick Ceballos

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-13853 Issued in NC

Practice address

806 Hay St
Fayetteville, NC 28305-5312

Phone

(910) 860-7008

Fax

(910) 824-7593

NPI assigned

Aug 30, 2021

Last updated

Mar 22, 2024By the provider in NPPES

Sex

Male

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Haymount Institute for Psychological Services PLLCGroup PAC ID 1153498415, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Haymount Institute for Psychological Services, PLLC

  • Clinical Psychologist
  • Fayetteville, NC
  • NPI 1437320892
  Medicare reassignment Care Compare group
• Haymount Institute for Psychological Services, PLLC

  • Clinical Psychologist
  • Concord, NC
  • NPI 1316825656

  Physician Assistant

  NPD
• Atlanta Behavioral Medicine LLC

  • Psychiatry Physician
  • Alpharetta, GA
  • NPI 1093873812
  NPD

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1811664584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 CENTURY PKWY NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303453125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 HAY ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055312",
            "telephone_number": "910-860-7008",
            "fax_number": "910-824-7593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "308 Maxwell Rd Ste 600",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "300092068",
            "country_code": "US",
            "telephone_number": "678-205-4322",
            "fax_number": "470-336-7535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CEBALLOS",
        "first_name": "BRIAN",
        "middle_name": "PATRICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-30",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-13853",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11439",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean Joseph Catlett, MD
• Mallory Jade Cavanaugh
• Nicholas Cave
• Joshua Martin Caviness, RPH
• Cbok Solutions PLLC
• Amy S Cecchini, MS,PT
• Cedar Creek Assisted Living, LLC
• Jessica Lynn Cedeno, LCSW, MSW
• Eileen R. Cedzo, B.A.
• Celebrate Life Day Center, L.L.C.

• Physician Assistant in Fayetteville, NC
• Providers in Fayetteville, 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 Mar 22, 2024; 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.