Georgi N. Brockway, MD

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

2010-01342 Issued in NC

Practice address

100 Medical Park Dr
Suite 310
Concord, NC 28025-2948

Phone

(704) 403-2660

NPI assigned

Apr 19, 2007

Last updated

May 4, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NC, MN, IL3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Neurology

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Charlotte-Mecklenburg Hospital AuthorityGroup PAC ID 2961310685, 594 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

99

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gbrockway136795@carolinashealthcaresystem.direct-ci.com

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.

• The Charlotte-Mecklenburg Hospital Authority

  dba Levine Cancer Institute

  • Medical Oncology Physician
  • Indian Land, SC
  • NPI 1669738829

  NC

  Medicare reassignment Care Compare group NPD
• Carle Health Medical Group

  dba Carle Physician Group

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment NPD
• Gillette Children's Specialty Healthcare

  dba Gillette Children's Professional Services

  • Multi-Specialty Clinic/Center
  • Saint Paul, MN
  • NPI 1225119175
  Medicare reassignment NPD
• The Board of Trustees of the University of Illinois

  • Anatomic Pathology Physician
  • Chicago, IL
  • NPI 1386863819
  Medicare reassignment NPD
• The Charlotte-Mecklenburg Hospital Authority

  dba Atrium Health Levine Children's Neurology

  • Neurology with Special Qualifications in Child Neurology Physician
  • Concord, NC
  • NPI 1396172516
  NPD
• The Charlotte-Mecklenburg Hospital Authority

  dba Atrium Health Pineville Rehabilitation Hospital

  • Rehabilitation Hospital Unit
  • Charlotte, NC
  • NPI 1962987131
  NPD
• Board of Trustees of the University of Illinois

  dba Medical Service Plan at Peoria

  • Pediatrics Physician
  • Peoria, IL
  • NPI 1467425322
  NPD
• Gillette Children's Specialty Healthcare

  • Multi-Specialty Clinic/Center
  • Saint Cloud, MN
  • NPI 1982090528
  NPD
• The Board of Trustees of the University of Illinois

  dba Occupational Health Service Institute (OHSI)

  • Occupational Medicine Physician
  • Chicago, IL
  • NPI 1043727571
  NPD
• CMC-Northeast, Inc.

  dba Carolinas Pediatric Neurology Care - Huntersville

  • Neurology with Special Qualifications in Child Neurology Physician
  • Huntersville, NC
  • NPI 1457557795
  NPD (past)
• The Charlotte-Mecklenburg Hospital Authority

  dba Atrium Health Levine Children's Neurology

  • Neurology Physician
  • Huntersville, NC
  • NPI 1225465362
  NPD (past)
• Carle Health Care Incorporated

  • Durable Medical Equipment & Medical Supplies
  • Champaign, IL
  • NPI 1114240876
  NPD (past)

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1962629139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL PARK DR",
            "address_2": "SUITE 310",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252948",
            "telephone_number": "704-403-2660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1781 Tate Blvd SE",
            "address_purpose": "LOCATION",
            "city": "Hickory",
            "state": "NC",
            "postal_code": "286024251",
            "country_code": "US",
            "telephone_number": "704-446-1900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9625 Northcross Center Ct",
            "address_2": "Ste 102B",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280787348",
            "country_code": "US",
            "telephone_number": "704-801-1240",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2550 Court Dr",
            "address_2": "Ste 203",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280542152",
            "country_code": "US",
            "telephone_number": "704-381-1450",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6600 W Wilkinson Blvd",
            "address_purpose": "LOCATION",
            "city": "Belmont",
            "state": "NC",
            "postal_code": "280122796",
            "country_code": "US",
            "telephone_number": "704-381-1450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROCKWAY",
        "first_name": "GEORGI",
        "middle_name": "N.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NC",
            "license": "2010-01342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gbrockway136795@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "100 Medical Park Dr",
            "address_2": "Suite 310",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280252948",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ariel Brittain, MSW, LCSWA
• Daniel James Brittan, PA
• Leon Charles Britton, M.D.
• Camille Brock
• Courtney Ann Brockmiller, FNP-BC
• Angela Brooks-Livingston, NCC, LPC
• Cheryl Yvette Brooks, LCSW
• Crystal Yvette Brooks, LCSW
• Jada Brooks
• Jada B Brooks

• Neurology with Special Qualifications in Child Neurology Physician in Concord, NC
• Providers in Concord, NC by specialty
• Neurology with Special Qualifications in Child Neurology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; 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.
• 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.