Individual provider Active NPI

Equiena Nicole Scott, FNP

  • Family Nurse Practitioner
  • High Point, NC
National Provider Identifier
1043564164
Registry record updated Oct 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5005880 Issued in NC
Practice address
1814 Westchester Dr
Suite 301
High Point, NC 27262-7299
Phone
(336) 802-2025
Fax
(336) 802-2026
NPI assigned
Oct 29, 2012
Last updated
Oct 31, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5005880 NC Primary

Addresses

Primary practice location

1814 Westchester Dr
Suite 301
High Point, NC 27262-7299

Mailing address

1701 Westchester Dr
Suite 850
High Point, NC 27262-7008
Phone (336) 802-2400

Other identifiers 2

IdentifierTypeStateIssuer
7006408MedicaidNC
181PUOtherNCBCBS

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
I20130103000112 NC Practitioner - Nurse Practitioner 8527211325 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5005880NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physiatry Consultants of NC PLLC CurrentSince Aug 6, 2021 Accepting new patients
Cornerstone Health Care PA Past Accepting new patients

Locations

415 W Golf Rd
Ste 26
Arlington Hts, IL 60005

1 Pond St
Arden, NC 28704
Phone 82877452220027

1 Marithe Ct
Greensboro, NC 27407
Phone (336) 852-9700

5533 Burlington Rd
Mc Leansville, NC 27301
Phone (336) 698-0045

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1351468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446249600000",
    "number": "1043564164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 WESTCHESTER DR",
            "address_2": "SUITE 850",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627008",
            "telephone_number": "336-802-2400",
            "fax_number": "336-802-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 WESTCHESTER DR",
            "address_2": "SUITE 301",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627299",
            "telephone_number": "336-802-2025",
            "fax_number": "336-802-2026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "EQUIENA",
        "middle_name": "NICOLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-29",
        "last_updated": "2015-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5005880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7006408",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "181PU",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

Verify at the official NPI Registry.