NPIMap

Individual provider Active NPI

Bryn Avery Anderson

  • Physician Assistant
  • Mount Airy, NC
National Provider Identifier
1922638394
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-09741 Issued in NC
Practice address
1016 S South St
Mount Airy, NC 27030-5330
Phone
(336) 786-6277
Fax
(336) 786-6747
NPI assigned
Jan 24, 2020
Last updated
Apr 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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 0010-09741 NC Primary

Addresses

Primary practice location

1016 S South St
Mount Airy, NC 27030-5330

Mailing address

708 S South St Ste 100
Mount Airy, NC 27030-4589
Phone (336) 786-6277

Other practice location 1

708 S South St Ste 100
Mount Airy, NC 27030-4589
Phone (336) 786-6277

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address banderson@wearenorthern.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200313000521 NC Practitioner - Physician Assistant 9638507221 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Brody School of Medicine at East Carolina University, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1016 S S St
Mount Airy, NC 27030-5330
Phone (336) 783-8900

423 S S St
Mount Airy, NC 27030-4576
Phone (336) 786-5144

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Hospital of Surry County CurrentSince Mar 1, 2023 Accepting new patients
Northern Hospital of Surry County CurrentSince Mar 1, 2023 Accepting new patients
Northern Hospital District of Surry County CurrentSince Mar 1, 2023 Accepting new patients
Northern Hospital District of Surry County PastSince Apr 6, 2021 Accepting new patients

Locations

1016 S South St
Mount Airy, NC 27030
Phone (336) 783-8900

119 Welch Rd
Ste A
Mount Airy, NC 27030
Phone (336) 719-6200

423 S South St
Mount Airy, NC 27030
Phone (336) 786-5144

708 S South St
Ste 100
Mount Airy, NC 27030
Phone (336) 698-4055

830 Rockford St
Mount Airy, NC 27030
Phone (336) 719-7000

Interoperability endpoints

  • Direct secure messaging: banderson@wearenorthern.org

Organizations & group practices 6

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.

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": "1579824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1922638394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 S SOUTH ST STE 100",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270304589",
            "telephone_number": "336-786-6277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 S SOUTH ST",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270305330",
            "telephone_number": "336-786-6277",
            "fax_number": "336-786-6747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "708 S South St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Mount Airy",
            "state": "NC",
            "postal_code": "270304589",
            "country_code": "US",
            "telephone_number": "336-786-6277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "BRYN",
        "middle_name": "AVERY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-24",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-09741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "banderson@wearenorthern.org",
            "affiliation": "N",
            "address_1": "1016 S South St",
            "city": "Mount Airy",
            "state": "NC",
            "country_code": "US",
            "postal_code": "270305330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Airy, NC

Sources for this page

Verify at the official NPI Registry.