GEORGI BROCKWAY (NPI# 1962629139) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1962629139 |
Entity Type | Individual |
Full Name | GEORGI BROCKWAY |
Credential | MD |
Practice Address |
100 Medical Park Dr Suite 310 Concord NC 28025-2948 |
Mailing Address |
Po Box 19305 Charlotte NC 28219-9305 |
Practice Telephone | 7044032660 |
Enumeration Date | 2007-04-19 |
Last Update Date | 2020-09-25 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
2010-01342 | NC | Allopathic & Osteopathic Physicians |
Address | Telephone Number | Fax Number |
---|---|---|
1781 Tate Blvd Se, Hickory, NC 286024251 | 7044461900 | |
2550 Court Dr, Ste 203, Gastonia, NC 280542152 | 7044032660 | |
6600 W Wilkinson Blvd, Belmont, NC 280122796 | 7044461900 | |
9625 Northcross Center Ct, Suite 102b, Huntersville, NC 280787348 | 7048011240 |
Street Address |
100 MEDICAL PARK DR SUITE 310 |
City | CONCORD |
State | NC |
Zip Code | 28025-2948 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700882958 | Patrick Anonick | Internal Medicine | 100 Medical Park Dr, Ste 210, Concord, NC 28025-2948 | 2005-06-22 |
1538700620 | Ashley Stewart | Nurse Practitioner | 100 Medical Park Dr, Ste 210, Concord, NC 28025-2948 | 2019-10-01 |
1659858330 | Krista Diiorio | Nurse Practitioner | 100 Medical Park Dr, Suite 310, Concord, NC 28025-2948 | 2018-07-25 |
1255829768 | Jessica Beal | Physician Assistant | 100 Medical Park Dr, Ste 110, Concord, NC 28025-2948 | 2018-04-30 |
1093216244 | Chris Larck | Pharmacist | 100 Medical Park Dr, Concord, NC 28025-2948 | 2018-02-23 |
1164948022 | Kathleen Bloom | Nurse Practitioner | 100 Medical Park Dr, Ste 210, Concord, NC 28025-2948 | 2017-08-22 |
1043736713 | Lauren Cartwright | Physician Assistant | 100 Medical Park Dr, Ste 210, Concord, NC 28025-2948 | 2017-08-15 |
1013439892 | Brittany Dillon | Nurse Practitioner | 100 Medical Park Dr, Suite 310, Concord, NC 28025-2948 | 2017-07-12 |
1932650892 | Kevin Hixson | Physician Assistant | 100 Medical Park Dr, Ste 210, Concord, NC 28025-2948 | 2016-10-17 |
1891243929 | Scott Palmer | Nurse Practitioner | 100 Medical Park Dr, Ste 110, Concord, NC 28025-2948 | 2016-09-19 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053910729 | Renewed Mindset Therapeutic Services, Pllc | Social Worker | 349 Copperfield Blvd Suite L #334, Concord, NC 28025 | 2020-10-22 |
1194284380 | Carolinas Physicians Network Inc | Internal Medicine | 610 Alfred Brown Jr. Court, Concord, NC 28025 | 2019-03-18 |
1164913596 | Damarius Raymond Faggart | Counselor | 503 Amhurst Drive, Concord, NC 28025 | 2018-05-22 |
1437677085 | Kathryn Emily Kanauer | Counselor | 280 Executive Park Dr Ne, Concord, NC 28025 | 2017-09-05 |
1649794439 | Foster Health & Homecare, LLC | Home Health | 363 Church Street North, Suite 260-i, Concord, NC 28025 | 2017-08-02 |
1326569336 | Jessie Leigh Tilley-compton | Social Worker | 371 Amhurst St Sw, Concord, NC 28025 | 2017-06-29 |
1609305663 | Sarah Katherine Thompson | Licensed Practical Nurse | 248 Executive Park Dr, Concord, NC 28025 | 2017-06-05 |
1023463098 | Kiera Brown | Social Worker | 219 Lephillip Court, Concord, NC 28025 | 2016-04-27 |
1992169445 | Brittiny N. Ingram Vanterpool | Counselor | 250 Branchview Dr Sw, Concord, NC 28025 | 2016-04-11 |
1215399852 | The Charlotte-mecklenburg Hospital Authority | Clinic/Center | 840 Warren C. Coleman Blvd, Concord, NC 28025 | 2016-03-23 |
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Taxonomy Code | 2084N0402X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Neurology with Special Qualifications in Child Neurology |
A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164987616 | Novant Medical Group Inc | Psychiatry & Neurology | 311 Coddle Market Dr Nw, Ste 200, Concord, NC 28027-2432 | 2019-02-08 |
1396172516 | The Charlotte-mecklenburg Hospital Authority | Psychiatry & Neurology | 100 Medical Park Dr, Suite 310, Concord, NC 28025-2948 | 2013-10-02 |
1457520918 | Robet L Sieben, Md, Inc | Psychiatry & Neurology | 3301 Clayton Rd, Concord, CA 94519-2820 | 2008-02-28 |
1427177112 | Robert Leonard Sieben | Psychiatry & Neurology | 2425 East St, Suite 10, Concord, CA 94520-1928 | 2007-03-27 |
1093751471 | Timothy Scott Livingston | Psychiatry & Neurology | 100 Medical Park Dr, Suite 310, Concord, NC 28025-2966 | 2006-06-22 |
1730135047 | Carolinas Medical Center-northeast | Psychiatry & Neurology | 100 Medical Park Dr, Suite 310, Concord, NC 28025-2948 | 2006-05-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033675079 | Novant Medical Group Inc | Psychiatry & Neurology | 1918 Randolph Rd Ste 320, Charlotte, NC 28207-1109 | 2019-02-14 |
1740547496 | Dmitry Tchapyjnikov | Psychiatry & Neurology | Dept of Pediatrics Duke University Medical Ctr, 2301 Erwin Rd., Children's Health Center, Duke Universi, Durham, NC 27710-0001 | 2012-04-19 |
1043525280 | Cmc-northeast, Inc. | Psychiatry & Neurology | 6600 Wilkinson Blvd, Carolinas Pediatric Neurology Care - Holy Angels, Belmont, NC 28012-2796 | 2010-08-12 |
1750610689 | Virinder Nohria | Psychiatry & Neurology | 111 Skyline View Rd, Franklin, NC 28734-4769 | 2009-12-24 |
1144463993 | Monica Elizabeth Lemmon | Psychiatry & Neurology | Dumc 3936, Durham, NC 27710-6667 | 2009-04-09 |
1245431600 | Yael Shiloh-malawsky | Psychiatry & Neurology | 170 Manning Dr., Department of Neurology Cb#7025, Chapel Hill, NC 27514-4220 | 2007-05-31 |
1598795635 | Kadry R Allaboun | Psychiatry & Neurology | 115 Foothills Dr, Morganton, NC 28655-5152 | 2006-07-04 |
1962473033 | David Jay Jaffe | Psychiatry & Neurology | 508 Sandhurst Dr, A, Fayetteville, NC 28304-4434 | 2006-01-27 |
1558368936 | Susan B Boutilier | Psychiatry & Neurology | 2280 Hemby Ln, Greenville, NC 27834-3773 | 2005-06-30 |
1437629664 | Mission Community Anesthesiology Specialists LLC | Psychiatry & Neurology | 890 Hendersonville Rd Ste 200, Asheville, NC 28803-2997 | 2018-11-30 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.