Individual provider Active NPI

Stephanny Parker, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Jacksonville, NC
National Provider Identifier
1043978703
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5015948 Issued in NC
Practice address
200 Tarpon TRL
Jacksonville, NC 28546-5287
Phone
(910) 938-1114
Fax
(910) 938-1118
NPI assigned
Nov 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5015948 NC Primary

Addresses

Primary practice location

200 Tarpon TRL
Jacksonville, NC 28546-5287

Mailing address

284 Executive Park Dr Ste 100
Concord, NC 28025-1833
Phone (704) 939-1100

Other identifiers 1

IdentifierTypeStateIssuer
1043978709OtherNPI

Other names 1

  • Stephanny Parker Professional name

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
I20221021001050 NC Practitioner - Nurse Practitioner 3476940321 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Daymark Recovery Services IncGroup PAC ID 0547233975, 132 clinicians

Practice addresses (Care Compare)

110 W Walker Ave
FL 2
Asheboro, NC 27203-6760
Phone (336) 633-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Daymark Recovery Services, Inc. CurrentSince Nov 12, 2024 Accepting new patients
Coastal Carolina Neuropsychiatric Center, PA CurrentSince Sep 1, 2022 Accepting new patients

Locations

110 W Walker Ave
Fl 2
Asheboro, NC 27203
Phone (336) 633-7000

616 Colonnade Dr
Charlotte, NC 28205
Phone (704) 273-3942

410 Denim Dr
Erwin, NC 28339
Phone (910) 230-4011

1200 Fairmont Ct
Fayetteville, NC 28304
Phone (910) 429-1114

200 Tarpon Trl
Jacksonville, NC 28546
Phone 9109381114139

284 Executive Park Dr
Ste 100
Kannapolis, NC 28025
Phone (704) 939-1118

1104A S Main St
Lexington, NC 27292
Phone (336) 300-8836

2129 Statesville Blvd
Salisbury, NC 28147
Phone (704) 633-3616

130 Carbonton Rd
Sanford, NC 27330
Phone (919) 774-6521

650 Highland Ave
Ste 110
Winston Salem, NC 27101
Phone (336) 597-2115

Interoperability endpoints

  • Direct secure messaging: stephanny.parker.p1@direct.daymarkrecovery.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1638230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1043978703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 EXECUTIVE PARK DR STE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251833",
            "telephone_number": "704-939-1100",
            "fax_number": "704-939-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 TARPON TRL",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465287",
            "telephone_number": "910-938-1114",
            "fax_number": "910-938-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "STEPHANNY",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-30",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5015948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1043978709",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANNY",
            "last_name": "PARKER",
            "credential": "PMHNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.