Jennifer Louise Percival

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

275979 Issued in NC

Practice address

5145 Sellers Rd
Shallotte, NC 28470-3405

Phone

(910) 754-4441

NPI assigned

Feb 12, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, shared by 14 NPIs, 2,413 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Brunswick Medical Center Hospital, Supply, NC, CCN 340158
• Novant Health New Hanover Regional Medical Center Hospital, Wilmington, NC, CCN 340141

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jschweer240316@direct.novanthealth.org

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.

• Novant Health Medical Group, LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Charlotte, NC
  • NPI 1306950282
  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  • Hospitalist Physician
  • Bolivia, NC
  • NPI 1558551671
  NPD
• Novant Health Medical Group, LLC

  • Family Medicine Physician
  • Shallotte, NC
  • NPI 1710051123
  NPD
• Novant Health Medical Group, LLC

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1134841802
  NPD (past)

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

• Brunswick Community Hospital, LLC

  • General Acute Care Hospital
  • Bolivia, NC
  • NPI 1710915756
  Care Compare affiliation
• Novant Health New Hanover Regional Medical Center LLC

  • General Acute Care Hospital
  • Wilmington, NC
  • NPI 1376139139
  Care Compare affiliation

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

{
    "created_epoch": "1423699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1053702076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "910-754-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5145 SELLERS RD",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284703405",
            "telephone_number": "910-754-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERCIVAL",
        "first_name": "JENNIFER",
        "middle_name": "LOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-12",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "275979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053702076",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jschweer240316@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "5145 Sellers Rd",
            "city": "Shallotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284703405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Open Gate Counseling Services PLLC
• Madalyn Grace Osbahr
• Jennifer Mary Palecek, LCSWA
• Kari Papagikos
• Adrienne Park
• Peter Grumbos DDS Shallotte PLLC
• Phelps Family Practice, PLLC
• Danny C Phipps, DOCTOR OF MINISTRY
• Frank R Pinto, P.T.
• Robert Todd Pitts, NP

• Nurse Practitioner in Shallotte, NC
• Providers in Shallotte, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.