KELLI NICHOLS CASE (NPI# 1124290283) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124290283 |
| Entity Type | Individual |
| Full Name | KELLI NICHOLS CASE |
| Credential | FNP-C |
| Practice Address |
152 E Kinderton Way Ste 101 Bermuda Run NC 27006 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 3368933180 |
| Practice Fax Number | 3368933189 |
| Mailing Telephone | 3368933180 |
| Mailing Fax Number | 3368933189 |
| Enumeration Date | 2008-03-29 |
| Last Update Date | 2020-10-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 117193 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7000723 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2025 Frontis Plaza Blvd, Suite 120, Winston Salem, NC 271035663 | 3362772200 | 3362772210 |
| Street Address |
152 E KINDERTON WAY STE 101 |
| City | BERMUDA RUN |
| State | NC |
| Zip Code | 27006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174144406 | Emily Church Spencer | Nurse Practitioner | 152 E Kinderton Way Ste 101, Bermuda Run, NC 27006-7351 | 2020-04-28 |
| 1124511985 | Novant Medical Group, Inc. | Internal Medicine | 152 E Kinderton Way Ste 101, Bermuda Run, NC 27006 | 2018-06-07 |
| 1902398985 | Novant Medical Group, Inc | Neurological Surgery | 152 E Kinderton Way Ste 101, Bermuda Run, NC 27006-7351 | 2018-06-05 |
| 1265924468 | Novant Medical Group, Inc. | Psychiatry & Neurology | 152 E Kinderton Way Ste 101, Bermuda Run, NC 27006 | 2018-06-04 |
| 1326466574 | Kent Cochran | Anesthesiology | 152 E Kinderton Way Ste 101, Bermuda Run, NC 27006 | 2014-04-04 |
| 1750585170 | Dittana Phoncharoensri | Psychiatry & Neurology | 152 E Kinderton Way Ste 101, Bermuda Run, NC 27006-7351 | 2007-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942811567 | Venessa Brunt | Home Health | 271 Orchard Park Drive, Advance, NC 27006 | 2020-08-17 |
| 1730707928 | Dara Elzena Green | Physical Therapist | 142 Hollybrook Dr, Advance, NC 27006 | 2020-07-14 |
| 1104339084 | Mark Curry Maynard | Registered Nurse | 125 W Robin Dr, Advance, NC 27006 | 2017-11-14 |
| 1457781585 | Christa Cook | Physical Therapist | 316 N Carolina 801, Advance, NC 27006 | 2013-11-27 |
| 1801029582 | Bonnie T. Bergen | Pharmacist | 260 Us Hwy 801 N, Advance, NC 27006 | 2009-08-28 |
| 1073745485 | Digestive Health Specialists, Pa | Internal Medicine | 112 Kinderton Blvd, Advance, NC 27006 | 2009-08-18 |
| 1114101078 | Dr. Todd Carter D.d.s | Dentist | 123 Nc Highway 801 S. #c-100, Advance, NC 27006 | 2007-12-27 |
| 1437373883 | Adam T. Dorsett | Dentist | 127 Royal Troon Ln, Advance, NC 27006 | 2007-04-13 |
| 1861583882 | Todd H Carter | Dentist | 123 Nc Hwy 801 South, C-100, Advance, NC 27006 | 2006-09-27 |
| 1104927987 | Eckerd Corporation | Durable Medical Equipment & Medical Supplies | 260 Highway 801, Advance, NC 27006 | 2006-09-26 |
| Find all providers in zip 27006 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174144406 | Emily Church Spencer | Nurse Practitioner | 152 E Kinderton Way Ste 101, Bermuda Run, NC 27006-7351 | 2020-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841891959 | Amanda Lou Nester | Nurse Practitioner | 5293 Wayne Memorial Dr, Goldsboro, NC 27534-7257 | 2020-11-04 |
| 1902406671 | Lilly Danielle Appleberry | Nurse Practitioner | 6005 Clarks Fork Dr, Raleigh, NC 27616-5821 | 2020-10-30 |
| 1457950255 | Ronda Kaye Mckinney | Nurse Practitioner | 27 Resort Dr, Asheville, NC 28806-3815 | 2020-10-22 |
| 1215544986 | Tonya Lynn Burris | Nurse Practitioner | 7810 Providence Rd Ste 102, Charlotte, NC 28226-2987 | 2020-09-28 |
| 1609482280 | Deanna Mclamb | Nurse Practitioner | 3102 Bell Arthur Rd, Greenville, NC 27834-4758 | 2020-09-19 |
| 1548873664 | Rosalynn Maria Solis | Nurse Practitioner | 1407 Regal View Dr, Kernersville, NC 27284-0060 | 2020-08-28 |
| 1003428293 | Kashari Davis | Nurse Practitioner | 4252 Sutwick Dr, Charlotte, NC 28269-6001 | 2020-08-19 |
| 1861003709 | Raymond William Meyers | Nurse Practitioner | 1604 Pelham Rd, Winterville, NC 28590-9131 | 2020-08-13 |
| 1700495553 | Evergreen Emmejune Haverkamp | Nurse Practitioner | 545 Schultz Cir, Newland, NC 28657-7714 | 2020-07-28 |
| 1770191835 | Brandy Sampson | Nurse Practitioner | 2900 Old House Cir, Matthews, NC 28105-7279 | 2020-07-15 |
| Find all providers with the same taxonomy | ||||
| City | BERMUDA RUN |
| Zip Code | 27006 |
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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.