Individual provider Active NPI

Nicole Harrison, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1003463134
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5021305 Issued in NC
Practice address
1708 Trawick Rd Ste 115
Raleigh, NC 27604-3897
Phone
(919) 841-2465
Fax
(919) 747-9462
NPI assigned
Aug 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 230461 NC
Continuing Education/Staff Development Registered Nurse 163WC1600X 230461 NC
Clinical Medical Laboratory 291U00000X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5021305 NC Primary

Addresses

Primary practice location

1708 Trawick Rd Ste 115
Raleigh, NC 27604-3897

Mailing address

5001 Babbling Brook Dr
Raleigh, NC 27610-5369
Phone (919) 841-2465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250424000338 NC Practitioner - Nurse Practitioner 7113443052 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Group practices
Eventus Wholehealth PLLCGroup PAC ID 6002169539, 301 clinicians
Eventus WH Southeast, LLCGroup PAC ID 5496294456, 241 clinicians
Triad Behavioral Resources PCGroup PAC ID 7911316435, 8 clinicians

Practice addresses (Care Compare)

101 Cabarrus Ave E
Suite 200
Concord, NC 28025-3781
Phone (855) 743-2247

212 S Tryon St
Suite 1000
Charlotte, NC 28281-0006
Phone (855) 743-2247

6626 Gordon Rd
Suite C
Wilmington, NC 28411-8424
Phone (910) 765-1003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
230461NCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Eventus Wholehealth, PLLC Psychiatric/Mental Health CurrentSince Mar 14, 2025 Accepting new patients
Eventus WH Southeast, LLC CurrentSince May 2, 2025 Accepting new patients
Eventus WH PLLC Care, LLC CurrentSince Sep 1, 2025 Accepting new patients
Triad Behavioral Resources PC CurrentSince Apr 1, 2025 Accepting new patients
Rhodium Care Group PLLC CurrentSince Jul 11, 2025 Accepting new patients
Eventus Value Care, LLC CurrentSince Oct 17, 2025 Accepting new patients
Harmonize Your Mental Health LLC Current Accepting new patients
RNS Within Reach Teaching Services Clinical Medical Laboratory Current Accepting new patients

Locations

212 S Tryon St
Ste 1000
Charlotte, NC 28281
Phone (512) 575-8028

2810 Coliseum Centre Dr
Ste 120
Charlotte, NC 28217

1300 Don Juan Rd
Hertford, NC 27944
Phone (252) 426-4066

1708 Trawick Rd
Ste 115
Raleigh, NC 27604
Phone (919) 594-1201

12 N 5th Ave
Wilmington, NC 28401
Phone (910) 765-1003

6626 Gordon Rd
Ste C
Wilmington, NC 28411
Phone (910) 765-1003

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1003463134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 BABBLING BROOK DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276105369",
            "telephone_number": "919-841-2465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 TRAWICK RD STE 115",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276043897",
            "telephone_number": "919-841-2465",
            "fax_number": "919-747-9462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-22",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "230461",
            "primary": false
        },
        {
            "code": "163WC1600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Continuing Education/Staff Development",
            "state": "NC",
            "license": "230461",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5021305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.