ERICA MATHIS SHORE (NPI# 1609428887) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609428887 |
| Entity Type | Individual |
| Full Name | ERICA MATHIS SHORE |
| Credential | FNP |
| Practice Address |
1370 W D St North Wilkesboro NC 28659-3506 |
| Mailing Address |
306 College St Wilkesboro NC 28697-2854 |
| Practice Telephone | 3367162255 |
| Mailing Telephone | 3366517533 |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2020-05-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 5011954 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
5011954 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 306 College St, Wilkesboro, NC 286972854 | 3366517533 |
| Street Address |
1370 W D ST |
| City | NORTH WILKESBORO |
| State | NC |
| Zip Code | 28659-3506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699778639 | John C Canon | Emergency Medicine | 1370 W D St, North Wilkesboro, NC 28659-3506 | 2005-05-23 |
| 1275028011 | Kaisey Hampton Medley | Physician Assistant | 1370 W D St, North Wilkesboro, NC 28659-3506 | 2018-06-25 |
| 1679007066 | Jenna Kay Baker | Physician Assistant | 1370 W D St, North Wilkesboro, NC 28659 | 2017-04-12 |
| 1548792153 | Blake Briggs | Emergency Medicine | 1370 W D St, North Wilkesboro, NC 28659-3506 | 2017-04-02 |
| 1881053064 | Jeffrey Forsyth | Physician Assistant | 1370 W D St, North Wilkesboro, NC 28659-3506 | 2016-02-17 |
| 1093190795 | Russell Nathan Worthen | Nurse Practitioner | 1370 W D St, North Wilkesboro, NC 28659-3506 | 2015-07-23 |
| 1457731028 | Mitchell Adams | Physician Assistant | 1370 W D St, North Wilkesboro, NC 28659-3506 | 2015-06-09 |
| 1629455258 | Willard Jeffrey Shew | Nurse Anesthetist, Certified Registered | 1370 W D St, North Wilkesboro, NC 28659-3506 | 2015-05-04 |
| 1194116756 | Joshua Isaac Troyer | Nurse Anesthetist, Certified Registered | 1370 W D St, North Wilkesboro, NC 28659-3506 | 2015-02-17 |
| 1831599208 | Heather Goodwyn | Nurse Anesthetist, Certified Registered | 1370 W D St, North Wilkesboro, NC 28659-3506 | 2014-09-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013579689 | Lisa C Carr | Social Worker | 1400 Willow Ln # C61-2, North Wilkesboro, NC 28659 | 2019-07-03 |
| 1780141507 | Brenda Barber | Counselor | 200 Northview Plaza, North Wilkesboro, NC 28659 | 2019-02-28 |
| 1639696941 | Lifespan Incorporated | Community/Behavioral Health | 2070 River Road, North Wilkesboro, NC 28659 | 2017-08-28 |
| 1184146011 | Daymark Recovery Services Inc | Community/Behavioral Health | 200 C.c. Wright School Road, Classrooms 126, 127, North Wilkesboro, NC 28659 | 2017-07-12 |
| 1033568258 | Rgm Al Holdings, LLC | Assisted Living Facility | 240 Independence Ave, North Wilkesboro, NC 28659 | 2016-06-08 |
| 1376997999 | Hayden Church | Driver | 29 Boone Trail, North Wilkesboro, NC 28659 | 2016-04-20 |
| 1033563192 | Nathan Grant Davis | Emergency Medicine | Wake Forest Baptist Health- Wilkes Medical Center, 1370 W D St, North Wilkesboro, NC 28659 | 2016-04-14 |
| 1720425408 | Lindsay Brooke Spears | Dentist | 1915 West Park Drive Ste 104, Wilkes Public Health Dental West, North Wilkesboro, NC 28659 | 2013-06-04 |
| 1881983419 | Pruitthealth Hospice, Inc. | Hospice Care, Community Based | 902 West D St, Ste B, North Wilkesboro, NC 28659 | 2011-04-05 |
| 1275838096 | Barium Springs Home for Children | Community Based Residential Treatment Facility, Mental Illness | 517 Boston Ave, North Wilkesboro, NC 28659 | 2011-01-26 |
| Find all providers in zip 28659 | ||||
| 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 |
|---|---|---|---|---|
| 1134776214 | Amy T Lankford | Nurse Practitioner | 190 Independence Ave Ste B, North Wilkesboro, NC 28659-4270 | 2019-08-22 |
| 1356819320 | Michael R Royall Jr. | Nurse Practitioner | 190 Independence Ave Ste B, North Wilkesboro, NC 28659-4270 | 2018-11-08 |
| 1184100570 | Amanda Johnson Turner | Nurse Practitioner | 1919 W Park Dr, North Wilkesboro, NC 28659-3564 | 2018-07-18 |
| 1265965669 | Deanna Dillon | Nurse Practitioner | 1919 W Park Dr, North Wilkesboro, NC 28659-3564 | 2017-04-04 |
| 1437525060 | Cynthia Randall Eller | Nurse Practitioner | 1900 W Park Dr, North Wilkesboro, NC 28659-3563 | 2015-08-18 |
| 1225419625 | Travis Money | Nurse Practitioner | 1909 W Park Dr, North Wilkesboro, NC 28659-3564 | 2015-06-11 |
| 1659631083 | Pamela Lynn Aiken | Nurse Practitioner | 1405 Willow Ln, Suite B, North Wilkesboro, NC 28659-3551 | 2012-05-18 |
| 1952442527 | Pamela S Sloop | Nurse Practitioner | 112 Boone Trl, North Wilkesboro, NC 28659-3514 | 2007-02-08 |
| 1801992334 | Tracey Elledge Sheets | Nurse Practitioner | 1919 W Park Dr, North Wilkesboro, NC 28659-3564 | 2006-09-15 |
| 1255311320 | Denise Johnston | Nurse Practitioner | 1370 W D St, North Wilkesboro, NC 28659-3506 | 2006-01-17 |
| Find all providers in NORTH WILKESBORO | ||||
| City | NORTH WILKESBORO |
| Zip Code | 28659 |
Please comment or provide details below to improve the information on ERICA MATHIS SHORE.
| 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.