Individual provider Active NPI

Gina Wynne Taylor, FNP

  • Family Nurse Practitioner
  • Louisburg, NC
National Provider Identifier
1033855473
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
133058 Issued in NC
Practice address
1501 N Bickett Blvd
Louisburg, NC 27549-2178
Phone
(919) 497-8382
Fax
(919) 497-8385
NPI assigned
May 9, 2022
Last updated
Apr 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 133058 NC Primary
Family Medicine Physician 207Q00000X 133058 NC

Addresses

Primary practice location

1501 N Bickett Blvd
Louisburg, NC 27549-2178

Mailing address

511 Ruin Creek Rd Ste 101
Henderson, NC 27536-5919
Phone (252) 436-0440

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
I20221013003527 NC Practitioner - Nurse Practitioner 2365818457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1501 N Bickett Blvd
Suite E
Louisburg, NC 27549-2178
Phone (919) 497-8380

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
133058NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Maria Parham Physician Practices, LLC Family Medicine Current Accepting new patients
DLP Maria Parham Physician Practices LLC Family Medicine CurrentSince Sep 1, 2022 Accepting new patients
DLP Maria Parham Physician Practices LLC CurrentSince Sep 1, 2022 Accepting new patients
DLP Maria Parham Physician Practices, LLC Past Accepting new patients

Locations

120 Charles Rollins Rd
Ste 105
Henderson, NC 27536
Phone (252) 438-2773

511 Ruin Creek Rd
Ste 101
Henderson, NC 27536
Phone (252) 436-0440

1501 N Bickett Blvd
Ste E
Louisburg, NC 27549
Phone (919) 497-0445

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • Direct secure messaging: gina.taylor.1@20247.direct.athenahealth.com

Organizations & group practices 4

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1652054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1033855473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 RUIN CREEK RD STE 101",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275365919",
            "telephone_number": "252-436-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N BICKETT BLVD",
            "city": "LOUISBURG",
            "state": "NC",
            "postal_code": "275492178",
            "telephone_number": "919-497-8382",
            "fax_number": "919-497-8385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "GINA",
        "middle_name": "WYNNE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-09",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "133058",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "133058",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisburg, NC

Sources for this page

Verify at the official NPI Registry.