Individual provider Active NPI

Gerald Alfred Bynum, PAC

  • Physician Assistant
  • Fayetteville, NC
National Provider Identifier
1942268305
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
101260 Issued in NC
Practice address
5114 Yadkin Rd Ste 100
Fayetteville, NC 28303-3251
Phone
(910) 779-0454
Fax
(910) 578-5775
NPI assigned
May 3, 2006
Last updated
Oct 7, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2026

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 101260 NC Primary

Addresses

Primary practice location

5114 Yadkin Rd Ste 100
Fayetteville, NC 28303-3251

Mailing address

5411 Yadkin Rd.
Suite #100
Fayetteville, NC 28304
Phone (910) 797-0454

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
I20171110001043 NC Practitioner - Physician Assistant 8022374800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renew Counseling Center of NC LLCGroup PAC ID 7315224680, 2 clinicians

Practice addresses (Care Compare)

2212 Hope Mills Rd
Fayetteville, NC 28304-4228
Phone (910) 779-0454

National Provider Directory

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791331200000",
    "number": "1942268305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5411 YADKIN RD.",
            "address_2": "SUITE #100",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28304",
            "telephone_number": "910-797-0454",
            "fax_number": "910-491-0833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5114 YADKIN RD STE 100",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283033251",
            "telephone_number": "910-779-0454",
            "fax_number": "910-578-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYNUM",
        "first_name": "GERALD",
        "middle_name": "ALFRED",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "101260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.