Individual provider Active NPI

Brandy Bronk, PA-C

  • Physician Assistant
  • Fayetteville, NC
National Provider Identifier
1992662670
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
405 Owen Dr
Fayetteville, NC 28304-3411
Phone
(910) 323-3183
NPI assigned
Jan 6, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NC Primary

Addresses

Primary practice location

405 Owen Dr
Fayetteville, NC 28304-3411

Mailing address

405 Owen Dr
Fayetteville, NC 28304-3411
Phone (910) 323-3183

Other practice location 1

413 Owen Dr Ste 202
Fayetteville, NC 28304-3490
Phone (910) 401-5688

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
I20260128001418 NC Practitioner - Physician Assistant 7911485339

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3030 Northwest Expressway
Suite 1000
Oklahoma City, OK 73112-5468

405 Owen Dr
Fayetteville, NC 28304-3411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Raleigh Durham Medical Group PA CurrentSince Jan 9, 2026 Accepting new patients
Raleigh Durham Medical Group PA CurrentSince Jan 9, 2026 Accepting new patients

Locations

97 Cornerstone Dr
Cary, NC 27519
Phone (919) 460-0993

405 Owen Dr
Fayetteville, NC 28304
Phone (910) 323-3183

413 Owen Dr
Ste 202
Fayetteville, NC 28304
Phone (910) 323-3183

7124 US Highway 64 E
Knightdale, NC 27545
Phone (919) 266-6211

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1767657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1992662670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043411",
            "telephone_number": "910-323-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043411",
            "telephone_number": "910-323-3183"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "413 Owen Dr Ste 202",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043490",
            "country_code": "US",
            "telephone_number": "910-401-5688",
            "fax_number": "910-491-5846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRONK",
        "first_name": "BRANDY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-06",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.