Dorothy Nivens, NP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Midland, NC
NPI 1003261074 · NPPES record last updated Dec 1, 2022
Key facts
- NPI
- 1003261074
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 25235 (SC)
- Practice address
- 4363 Tucker Chase Dr
Midland, NC 28107-7812 - Phone
- (704) 322-9156
- NPI assigned
- Apr 27, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
110 Hazel Blakeney Rd
Pageland, SC 29728-6273
Phone (704) 322-9156
2124 N 2ND St
Suite 1070
Millville, NJ 08332-1304
Phone (704) 322-9156
2631 Housley Rd
Suite 1210
Annapolis, MD 21401-7030
Phone (704) 322-9156
4363 Tucker Chase Dr
Midland, NC 28107-7812
Phone (704) 322-9156
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (4 enrollments) in NC, SC, NJ, MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161108000804 | NC | Practitioner - Nurse Practitioner | 8820381890 | Reassigns benefits to 3 organizations |
| I20210901001925 | SC | Practitioner - Nurse Practitioner | 8820381890 | Reassigns benefits to 1 organization |
| I20231120000322 | NJ | Practitioner - Nurse Practitioner | 8820381890 | Reassigns benefits to 1 organization |
| I20231120000432 | MD | Practitioner - Nurse Practitioner | 8820381890 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Master of Arts, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25235 | SC | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Straight Walk Family Services, Inc | Current |
Accepting new patients | |
| Carolinas Pain Center PLLC | Current |
Accepting new patients | |
| Straight Walk Family Services | Current |
Accepting new patients | |
| Beautiful Mindz Behavioral Health and Wellness PLLC | Psychiatric/Mental Health | Current |
Accepting new patients |
| Lifesource of North Carolina | Nurse Practitioner | Current |
Accepting new patients |
Locations
2631 Housley Rd
Ste 1210
Annapolis, MD 21401
2631 Housley Rd
#1210
Annapolis, MD 21401
Phone (704) 322-9156
9735 Kincey Ave
Ste 100
Huntersville, NC 28078
Phone (704) 500-2332
505 Sunset Ave
Rocky Mount, NC 27804
Phone (252) 212-5524
401 S Pearl St
Williamston, NC 27892
Phone (252) 212-5524
3205 Randall Pkwy
Ste 105
Wilmington, NC 28403
Phone (910) 338-2880
2124 N 2nd St
Millville, NJ 08332
Phone (704) 322-9156
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 5008528 | NC | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 25235 | SC | Yes |
Addresses
Primary practice location
4363 Tucker Chase Dr
Midland, NC 28107-7812
Mailing address
4363 Tucker Chase Dr
Midland, NC 28107-7812
Phone (704) 322-9156
Other practice location 1
110 Hazel Blakeney Rd
Pageland, SC 29728-6273
Phone (704) 322-9156
Other providers in Midland, NC
- Robin Anne Manna
- Matthew L. Hubis DMD, PA
- Dennis Peter McKeon
- Dallas McSheehan
- Midland Transportation LLC
- Amanda Renee Nunez
- Oak Path Counseling Group, PLLC
- Maria Helene Oxford
- Neha Patil
- Carmella Morrow Pryor
All providers in Midland, NC · Psychiatric/Mental Health Nurse Practitioner in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.