Healthcare Provider Details

I. General information

NPI: 1396657813
Provider Name (Legal Business Name): HEALTHCENTRIX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2626 GLENWOOD AVE STE 310
RALEIGH NC
27608-1043
US

IV. Provider business mailing address

2626 GLENWOOD AVE STE 310
RALEIGH NC
27608-1043
US

V. Phone/Fax

Practice location:
  • Phone: 844-943-6175
  • Fax: 844-943-6175
Mailing address:
  • Phone: 844-943-6175
  • Fax: 844-943-6175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. BRANDON PARKER
Title or Position: DIRECTOR
Credential: MD
Phone: 844-943-6175