Individual provider Active NPI

Robert Kincaid Bruner, M.D.

  • Cardiovascular Disease Physician
  • Raleigh, NC
National Provider Identifier
1972599959
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
37797 Issued in NC
Practice address
5607 Shadowbrook Dr
Raleigh, NC 27612-5916
Phone
(919) 218-8585
NPI assigned
Sep 23, 2005
Last updated
Apr 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 37797 NC Primary

Addresses

Primary practice location

5607 Shadowbrook Dr
Raleigh, NC 27612-5916

Mailing address

5607 Shadowbrook Dr
Raleigh, NC 27612-5916
Phone (919) 218-8585

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040422001588 NC Practitioner - Cardiovascular Disease (Cardiology) 2264428499

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Wake Forest University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4201 Lake Boone TRL
Suite 104
Raleigh, NC 27607-7511

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Carolina MG, LLC Cardiovascular Disease CurrentSince Jun 1, 2025 Accepting new patients
Rex Hospital, Inc. Past Accepting new patients
Rex Hospital Inc Cardiovascular Disease Past Accepting new patients

Locations

10208 Cerny St
Ste 106
Raleigh, NC 27617
Phone (984) 215-4540

4201 Lake Boone Trl
Ste 104
Raleigh, NC 27607
Phone (919) 881-0160

4207 Lake Boone Trl
Ste 200
Raleigh, NC 27607
Phone (919) 782-3456

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

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 1

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": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776297600000",
    "number": "1972599959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5607 SHADOWBROOK DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276125916",
            "telephone_number": "919-218-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5607 SHADOWBROOK DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276125916",
            "telephone_number": "919-218-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNER",
        "first_name": "ROBERT",
        "middle_name": "KINCAID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "37797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.