Joan Shelton Phillips, FNPBC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5002927 Issued in NC

Practice address

13 Medical Campus Dr NW Ste 102
Supply, NC 28462-4093

Phone

(910) 754-5988

Fax

(910) 754-5989

NPI assigned

Mar 20, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Nurse Practitioner

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Family Ties of Brunswick, LLCGroup PAC ID 7911309430, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Family Ties of Brunswick, LLC

  • Professional Counselor
  • Wilmington, NC
  • NPI 1831682665
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1013032879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 MEDICAL CAMPUS DR NW STE 102",
            "city": "SUPPLY",
            "state": "NC",
            "postal_code": "284624093",
            "telephone_number": "910-754-5988",
            "fax_number": "910-754-5989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "951 Rockford St",
            "address_purpose": "LOCATION",
            "city": "Mount Airy",
            "state": "NC",
            "postal_code": "270305323",
            "country_code": "US",
            "telephone_number": "336-719-7993",
            "fax_number": "336-719-6550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JOAN",
        "middle_name": "SHELTON",
        "name_prefix": "Ms.",
        "credential": "FNPBC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "0050-02927",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5002927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "2592928",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7004010",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tina Paxton-Peeks
• Casey Madeline Payne
• Joanne Peck, MD
• Maizey Dawn Peek, LCSWA
• Amanda M Peters
• Nyisha Powell, CFPS
• Wendy Mechell Price, COTA/L
• Christian Dee Privette
• Stephanie A Reeves, LCSWA
• Paula Christine Reyes, PA-C

• Nurse Practitioner in Supply, NC
• Providers in Supply, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.