Individual provider Active NPI

Deborah Hupp

  • Family Nurse Practitioner
  • Wake Forest, NC
National Provider Identifier
1053500363
Registry record updated Dec 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
84271 Issued in NC
Practice address
245 East Roosevelt Ave
Minuteclinic Diagnostic of North Carolina
Wake Forest, NC 27587
Phone
(866) 389-2727
Fax
(401) 652-9787
NPI assigned
Oct 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2014

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 84271 NC Primary

Addresses

Primary practice location

245 East Roosevelt Ave
Minuteclinic Diagnostic of North Carolina
Wake Forest, NC 27587

Mailing address

9305 Glamis Cir
Wake Forest, NC 27587-1648
Phone (919) 453-1640

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
I20071213000143 NC Practitioner - Nurse Practitioner 5193815215 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic of North Carolina PCGroup PAC ID 6002837572, 208 clinicians

Practice addresses (Care Compare)

12000 Retail Dr
Wake Forest, NC 27587-7353
Phone (866) 389-2727

245 E Roosevelt Ave
Wake Forest, NC 27587-2719
Phone (866) 389-2727

6840 Glenwood Ave
Raleigh, NC 27612-7133
Phone (866) 389-2727

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
84271NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of North Carolina PC Family CurrentSince Aug 19, 2007 Accepting new patients
Minuteclinic Primary Care North Carolina PLLC Family CurrentSince Jun 4, 2025 Accepting new patients

Locations

10100 S Main St
Archdale, NC 27263
Phone (336) 431-0715

2340 Spring Forest Rd
Raleigh, NC 27615
Phone (919) 790-6401

6840 Glenwood Ave
Raleigh, NC 27612
Phone (401) 770-4415

245 E Roosevelt Ave
Wake Forest, NC 27587
Phone (919) 556-1900

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

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": "1193097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417651200000",
    "number": "1053500363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9305 GLAMIS CIR",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275871648",
            "telephone_number": "919-453-1640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 EAST ROOSEVELT AVE",
            "address_2": "MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "27587",
            "telephone_number": "866-389-2727",
            "fax_number": "401-652-9787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUPP",
        "first_name": "DEBORAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-23",
        "last_updated": "2014-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "84271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

Verify at the official NPI Registry.