Individual provider Active NPI

Bradley Christopher Kleinert, PA-C

  • Medical Physician Assistant
  • Clayton, NC
National Provider Identifier
1952035909
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0010-13952 Issued in NC
Practice address
12701 US 70W Business
Clayton, NC 27520-2195
Phone
(919) 235-1968
NPI assigned
Jul 14, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-13952 NC
Student in an Organized Health Care Education/Training Program 390200000X
Medical Physician Assistant 363AM0700X 0010-13952 NC Primary

Addresses

Primary practice location

12701 US 70W Business
Clayton, NC 27520-2195

Mailing address

PO Box 602195
Charlotte, NC 28260-2195
Phone (919) 350-0351

Other identifiers 1

IdentifierTypeStateIssuer
1952035909MedicaidNC

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
I20240327002318 NC Practitioner - Physician Assistant 0547607418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Specialty Physicians LLCGroup PAC ID 7416006085, 178 clinicians

Practice addresses (Care Compare)

10000 Falls of Neuse Rd
Raleigh, NC 27614-7838
Phone (919) 350-1300

126 Pritchard Rd
Clayton, NC 27527-9297
Phone (919) 235-1036

1260 N Arendell Ave
Zebulon, NC 27597-8730
Phone (919) 235-1965

12701 US 70 Business Hwy W
Clayton, NC 27520-2195
Phone (919) 350-0554

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-8000

6800 Glenwood Ave
Raleigh, NC 27612-7133
Phone (919) 235-1939

7750 Ten Ten Rd
Raleigh, NC 27603-8852
Phone (919) 235-1500

938 N Brightleaf Blvd
Smithfield, NC 27577-4331
Phone (919) 235-1525

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0010-13952NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Specialty Physicians, LLC CurrentSince Nov 18, 2024 Accepting new patients
Wake Specialty Physicians LLC CurrentSince Nov 18, 2024 Accepting new patients
Wake Specialty Physicians, LLC Physician Assistant Past Accepting new patients

Locations

10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300

938 N Brightleaf Blvd
Smithfield, NC 27577
Phone (919) 235-1525

Interoperability endpoints

  • Direct secure messaging: bkleinert564962@directhisp.wakemed.org

Organizations & group practices 3

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": "1657756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1952035909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602195",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602195",
            "telephone_number": "919-350-0351",
            "fax_number": "919-350-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12701 US 70W BUSINESS",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275202195",
            "telephone_number": "919-235-1968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEINERT",
        "first_name": "BRADLEY",
        "middle_name": "CHRISTOPHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-14",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-13952",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-13952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952035909",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, NC

Sources for this page

Verify at the official NPI Registry.