MEDICARE: CRESCENT FAMILY PRACTICE, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	0039359	NC

General Provider Information

NPI Number	:	1629129952
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRESCENT FAMILY PRACTICE, P.A.

Provider Business Mailing Address
First Line	:	1110 S.E. CARY PARKWAY
Second Line	:	STE 203
City	:	CARY
State	:	NC
Zip	:	27518-7420
Country	:	US
Telephone Number	:	919-851-7867
Fax Number	:	919-851-7866

Provider Business Practice Location Address
First Line	:	1110 S.E. CARY PARKWAY
Second Line	:	STE 203
City	:	CARY
State	:	NC
Zip	:	27518-7420
Country	:	US
Telephone Number	:	919-851-7867
Fax Number	:	919-851-7866

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOSEPH WALTER BRUCKERT
Credential	:	M.D.
Telephone Number	:	919-851-7867

Provider Enumeration Date	:	01/15/2007
Last Update Date	:	08/22/2020

Similar Medicare Providers

1114988292 — MRS. VIRGINIA A JETHRO PA-C
Practice Location Address:

1110 SE CARY PKWY , SUITE 206
CARY, NC
27518-7420

Practice Phone: 919-463-1101
Practice Fax: 919-463-1110

1720183387 — MS. ANNETTE LYNN TROY M.D.
Practice Location Address:

1110 SE CARY PARKWAY , SUITE 201
CARY, NC
27518-7420

Practice Phone: 919-851-6260
Practice Fax: 919-851-6261

1669547766 — WAKE NEUROLOGY PLLC
Practice Location Address:

1110 SE CARY PKWY , SUITE 206
CARY, NC
27518-7420

Practice Phone: 919-463-1101
Practice Fax: 919-463-1110

1326184870 — DR. CHRISTOPHER LIN MD
Practice Location Address:

1110 SE CARY PKWY
CARY, NC
27518-7420

Practice Phone: 919-297-0000
Practice Fax:

1801091343 — KELLY PATE NGUYEN NP
Practice Location Address:

1110 SE CARY PKWY , SUITE 206
CARY, NC
27518-7420

Practice Phone: 919-463-1101
Practice Fax: 919-463-1110

1184811663 — JULIE ELIZABETH ROCKEFELLER M.S. CCC-SLP
Practice Location Address:

1110 SE CARY PKWY
CARY, NC
27518-7420

Practice Phone: 919-595-2000
Practice Fax: 919-595-2190

Directions to “CRESCENT FAMILY PRACTICE, P.A. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.