Active NPI
Brady James Semmel, D.M.D., M.D.
- Oral and Maxillofacial Surgery (Dentist)
- Wilmington, NC
National Provider Identifier
1952399461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 200101495
- Practice address
- 1422 Commonwealth Dr
Wilmington, NC 28403-0302 - Phone
- (910) 509-1422
- Fax
- (910) 509-1421
- NPI assigned
- Oct 10, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 200101495 | NC | Primary |
Addresses
Primary practice location
1422 Commonwealth Dr
Wilmington, NC 28403-0302
Mailing address
1422 Commonwealth Dr
Wilmington, NC 28403-0302
Phone (910) 509-1422
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 131F4 | Other | NC | BLUE CROSS BLUE SHIELD |
| 10390209 | Other | NC | VOCATIONAL REHABILITATION |
| 89902FT | Medicaid | NC | |
| 89131F4 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Nov 24, 2014 through Nov 24, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200101495 | NC | MD | Oral and Maxillofacial Surgery (Dentist) |
| 8927 | NC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311552000000",
"number": "1952399461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1422 COMMONWEALTH DR",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284030302",
"telephone_number": "910-509-1422",
"fax_number": "910-509-1421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1422 COMMONWEALTH DR",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284030302",
"telephone_number": "910-509-1422",
"fax_number": "910-509-1421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEMMEL",
"first_name": "BRADY",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "D.M.D., M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-10",
"last_updated": "2011-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "NC",
"license": "200101495",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "131F4",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VOCATIONAL REHABILITATION",
"identifier": "10390209",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89902FT",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89131F4",
"state": "NC"
}
],
"endpoints": [],
"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 Jul 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.