Individual provider Active NPI

Blanche Elizabeth Brais, PA-C

  • Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1922086909
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
102831 Issued in NC
Practice address
105 Vest Mill Cir
Winston Salem, NC 27103-2943
Phone
(336) 718-7800
Fax
(336) 718-7900
NPI assigned
Jan 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 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 102831 NC Primary

Addresses

Primary practice location

105 Vest Mill Cir
Winston Salem, NC 27103-2943

Mailing address

PO Box 751803
Charlotte, NC 28275-1803

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bbrais4878@direct.novanthealth.org

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100227000079 NC Practitioner - Physician Assistant 0042355216 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians

Practice addresses (Care Compare)

105 Vest Mill Cir
Winston Salem, NC 27103-2943
Phone (336) 718-7800

291 Broad St
Kernersville, NC 27284-2932
Phone (336) 993-8181

6301 Stadium Dr
Clemmons, NC 27012-8766
Phone (336) 766-6473

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
102831NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Forsyth Memorial Hospital, Inc. CurrentSince Sep 8, 2003 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Sep 8, 2003 Accepting new patients
Forsyth Memorial Hospital, Inc Past Accepting new patients

Locations

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181

1995 Bethabara Rd
Winston Salem, NC 27106
Phone (336) 759-7596

105 Vest Mill Cir
Winston Salem, NC 27103
Phone (336) 718-7800

100 Robinhood Medical Plz
Winston Salem, NC 27106
Phone (336) 718-0560

3333 Brookview Hills Blvd
Ste 204
Winston Salem, NC 27103
Phone (336) 714-2730

Interoperability endpoints

  • Direct secure messaging: blanche.brais.1@17957.direct.athenahealth.com

Organizations & group practices 4

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 1

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": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1922086909",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 VEST MILL CIR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032943",
            "telephone_number": "336-718-7800",
            "fax_number": "336-718-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAIS",
        "first_name": "BLANCHE",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-09",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "102831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bbrais4878@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "105 Vest Mill Cir",
            "city": "Winston-Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271032943",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.