Charles D. Brickner, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD00039688 Issued in WA

Practice address

1351 Westgate Center Dr
Winston Salem, NC 27103-2934

Phone

(336) 718-7777

Fax

(336) 718-7744

NPI assigned

Aug 11, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: cbrickner1049044@carolinashealthcaresystem.direct-ci.com
• Direct secure messaging: cbrickner78392@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.

• Rockwood Clinic PS

  • Internal Medicine Physician
  • Spokane, WA
  • NPI 1417953787
  NPD
• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1003803032
  NPD (past)

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1912909748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "336-718-7777",
            "fax_number": "336-718-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 WESTGATE CENTER DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032934",
            "telephone_number": "336-718-7777",
            "fax_number": "336-718-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRICKNER",
        "first_name": "CHARLES",
        "middle_name": "D.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00039688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8278962",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CBRICKNER78392@DIRECT.NOVANTHEALTH.ORG",
            "affiliation": "N",
            "address_1": "1351 Westgate Center Dr",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271032934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michele Elizabeth Brewer, PT
• Brian Center Lane Operating Company, LLC
• Tionna Brice, LCSW
• Stacey L Brickell, CRNA
• Lara Brickhouse
• Dorinda Bricolo, CPNP-PC
• Bridge Counseling and Wellness, PLLC
• Julian Michael Bridges, LCSW
• Melissa Ricker Bridges, PA
• Sara Echols Bridges, LCSW

• All providers in Winston Salem, NC
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.