NPIMap

Individual provider Active NPI

Heather C Braithwaite, MD

  • Emergency Medicine Physician
  • Bolivia, NC
National Provider Identifier
1952364689
Registry record updated Jan 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
200400015 Issued in NC
Practice address
240 Hospital Dr NE
Bolivia, NC 28422-8346
Phone
(843) 497-5929
Fax
(843) 839-4448
NPI assigned
Apr 12, 2006
Last updated
Jan 20, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 200400015 NC Primary

Addresses

Primary practice location

240 Hospital Dr NE
Bolivia, NC 28422-8346

Mailing address

PO Box 3439
North Myrtle Beach, SC 29582-0439
Phone (843) 839-4447

Other identifiers 2

IdentifierTypeStateIssuer
89137G6MedicaidNC
Q15004MedicaidSC

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
I20040825001187 NC Practitioner - Emergency Medicine 9931173838 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
New York Medical College, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ecep II PAGroup PAC ID 5092709931, 23 clinicians

Practice addresses (Care Compare)

5301 Wrightsville Ave
Wilmington, NC 28403-6510
Phone (910) 202-3363

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.86 of 100Reported as group
Quality
97.48
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200400015NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tanglewood Park Physicians, PLLC Emergency Medicine CurrentSince Mar 19, 2019 Accepting new patients
Ecep II PA Emergency Medicine Current Accepting new patients
Piedmont Triad Physicians, PLLC Emergency Medicine CurrentSince Mar 1, 2019 Accepting new patients
Brunswick Physician Partners, PLLC Emergency Medicine CurrentSince Feb 1, 2019 Accepting new patients
Ecep II PA Emergency Medicine CurrentSince Oct 2, 2023 Accepting new patients
Brunswick Community Hospital, LLC CurrentSince Apr 9, 2018 Accepting new patients
Kernersville Emergency Group, PLLC Emergency Medicine CurrentSince Apr 1, 2019 Accepting new patients
Ecep II PA Emergency Medicine CurrentSince Oct 2, 2023 Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients
Pender Memorial Hospital, Incorporated Past Accepting new patients
Brunswick Community Hospital, LLC PastSince Oct 13, 2024 Accepting new patients
Solano Gateway Medical Group Inc Emergency Medicine Past 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

6915 Village Medical Cir
Clemmons, NC 27012
Phone (336) 718-1680

1750 Kernersville Medical Pkwy
Kernersville, NC 27284
Phone (336) 564-4000

207 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-2000

151 Scotts Hill Medical Dr
Wilmington, NC 28411
Phone (910) 662-8440

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

5301 Wrightsville Ave
Wilmington, NC 28403
Phone (910) 452-8100

Interoperability endpoints

  • Direct secure messaging: hbraithwaite423792@direct.novanthealth.org
  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 12

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 3

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": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484870400000",
    "number": "1952364689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3439",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295820439",
            "telephone_number": "843-839-4447",
            "fax_number": "843-399-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 HOSPITAL DR NE",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284228346",
            "telephone_number": "843-497-5929",
            "fax_number": "843-839-4448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAITHWAITE",
        "first_name": "HEATHER",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2017-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "200400015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89137G6",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q15004",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolivia, NC

Sources for this page

Verify at the official NPI Registry.