Nourish Adolescent Wellness

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

NOURISH ADOLESCENT WELLNESS

Practice address

307 S Salem St Ste 100
Apex, NC 27502-1845

Phone

(919) 627-8771

NPI assigned

Nov 2, 2020

Last updated

Sep 20, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sara Schaefer, CPNPNPI 1508466038

Title

Co-Owner

Phone

(919) 367-6639

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sara Heather Schaefer, CPNP

  • Pediatric Nurse Practitioner
  • Apex, NC
  • NPI 1508466038
  NPD Authorized official
• Kassondra Amada Shoemaker Brino, DNP, CPNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Butner, NC
  • NPI 1548746365
  NPD
• Haley Grace Gandsey, PNP

  • Pediatric Nurse Practitioner
  • Raleigh, NC
  • NPI 1295413458
  NPD

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

{
    "created_epoch": "1604275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663632000000",
    "number": "1033710637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S SALEM ST STE 100",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275021845",
            "telephone_number": "919-673-6639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 S SALEM ST STE 100",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275021845",
            "telephone_number": "919-627-8771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOURISH ADOLESCENT WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-02",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A",
        "authorized_official_last_name": "SCHAEFER",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "919-367-6639",
        "authorized_official_credential": "CPNP"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033710637",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• North Carolina Institute of Sports Biomechanics, LLC (B Young Physical Therapy)
• North Carolina Neuropsychiatry, P.a.
• Norville Eye Care, O.D., P.a.
• Danielle Denise Norville, O.D.
• Norma Yetzel Notario
• Nourishing Expert LLC
• Justine O'Callaghan
• Mary Knight O'Donnell, RPH
• Timothy Patrick O'Hare II
• Marissa Jamie O'Leary

• Primary Care Nurse Practitioner in Apex, NC
• Providers in Apex, NC by specialty
• Primary Care Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.