Individual provider Active NPI

Bryan Cole Chalk, CRNA

  • Certified Registered Nurse Anesthetist
  • Wilmington, NC
National Provider Identifier
1942550728
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
91147 Issued in NC
Practice address
2131 S 17TH Street
Wilmington, NC 28401
Phone
(910) 667-5831
NPI assigned
Sep 19, 2012
Last updated
Mar 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 91147 NC Primary

Addresses

Primary practice location

2131 S 17TH Street
Wilmington, NC 28401

Mailing address

7612 Culloden Court
Wilmington, NC 28411
Phone (252) 414-0453

Other practice location 1

1802 S 17th St
Wilmington, NC 28401-6444
Phone (910) 343-1031

Other practice location 2

6781 Parker Farm Dr Ste 200
Wilmington, NC 28405-3161
Phone (910) 343-1031

Other practice location 3

2305 Canterwood Dr
Wilmington, NC 28401-7300
Phone (910) 343-0119

Other practice location 4

510 Carolina Bay Dr Ste 100
Wilmington, NC 28403-2046
Phone (910) 763-9833

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bchalk74556@direct.nhrmc.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121203000425 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 4789836479 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2131 S 17TH St
Wilmington, NC 28401-7407
Phone (910) 343-7044

500 Jefferson St
Whiteville, NC 28472-3634
Phone (910) 642-8011

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
91147NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of North Carolina, PLLC Anesthesiology CurrentSince Oct 22, 2018 Accepting new patients
Pender Memorial Hospital Incorporated CurrentSince Jan 1, 2018 Accepting new patients
American Anesthesiology of North Carolina, PLLC Anesthesiology CurrentSince Oct 22, 2018 Accepting new patients
Coastal Carolina Sedation Associates, LLC Anesthesiology CurrentSince Mar 15, 2023 Accepting new patients
Columbus Regional Healthcare System CurrentSince Apr 1, 2024 Accepting new patients
Pender Memorial Hospital, Incorporated CurrentSince Jan 1, 2018 Accepting new patients
Columbus Regional Healthcare System CurrentSince Apr 1, 2024 Accepting new patients
Novant Health New Hanover Regional Medical Center LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2021 Accepting new patients
Novant Health New Hanover Regional Medical Center LLC CurrentSince Feb 1, 2021 Accepting new patients
NMG Southpark Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2018 Accepting new patients

Locations

240 Hospital Dr NE
Bolivia, NC 28422
Phone (336) 399-7678

507 E Fremont St
Burgaw, NC 28425
Phone (910) 259-5451

14215 Ballantyne Corporate Pl
Ste 210
Charlotte, NC 28277
Phone (704) 316-2650

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

6035 Fairview Rd
Charlotte, NC 28210
Phone (336) 718-2078

3100 Spring Forest Rd
Ste 130
Raleigh, NC 27616
Phone (919) 882-0705

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

612 Mocksville Ave
Salisbury, NC 28144
Phone (704) 210-5000

13 Medical Campus Dr NW
#101
Supply, NC 28462
Phone (910) 721-4300

500 Jefferson St
Whiteville, NC 28472
Phone (910) 642-1776

105 Scotts Hill Medical Dr
Wilmington, NC 28411
Phone (910) 686-2840

1802 S 17th St
Wilmington, NC 28401
Phone (910) 343-1031

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

2305 Canterwood Dr
Wilmington, NC 28401
Phone (910) 343-0119

510 Carolina Bay Dr
Ste 100
Wilmington, NC 28403
Phone (910) 338-0795

5115 Oleander Dr
Wilmington, NC 28403
Phone (910) 362-1011

6781 Parker Farm Dr
Ste 200
Wilmington, NC 28405
Phone (910) 343-1031

Organizations & group practices 10

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 2

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": "1348012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1942550728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7612 CULLODEN COURT",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "28411",
            "telephone_number": "252-414-0453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 S 17TH STREET",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "28401",
            "telephone_number": "910-667-5831"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1802 S 17th St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284016444",
            "country_code": "US",
            "telephone_number": "910-343-1031",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6781 Parker Farm Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284053161",
            "country_code": "US",
            "telephone_number": "910-343-1031",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2305 Canterwood Dr",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284017300",
            "country_code": "US",
            "telephone_number": "910-343-0119",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "510 Carolina Bay Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284032046",
            "country_code": "US",
            "telephone_number": "910-763-9833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHALK",
        "first_name": "BRYAN",
        "middle_name": "COLE",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-19",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "91147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bchalk74556@direct.nhrmc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "2131 S 17TH STREET",
            "city": "WILMINGTON",
            "state": "NC",
            "country_code": "US",
            "postal_code": "28401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.