Individual provider Active NPI

Stephanie Tyner Jones, NP

  • Nurse Practitioner
  • Whiteville, NC
National Provider Identifier
1053877084
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5011447 Issued in NC
Practice address
304 Jefferson St
Whiteville, NC 28472-3602
Phone
(910) 640-6615
Fax
(910) 640-1088
NPI assigned
Feb 14, 2019
Last updated
Feb 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5011447 NC Primary

Addresses

Primary practice location

304 Jefferson St
Whiteville, NC 28472-3602

Mailing address

304 Jefferson St
Whiteville, NC 28472-3602
Phone (910) 640-6615

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
I20190509001867 NC Practitioner - Nurse Practitioner 1557604758 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5011447NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Columbus Office of Accountant CurrentSince Mar 4, 2019 Accepting new patients

Locations

304 Jefferson St
Whiteville, NC 28472
Phone (910) 640-6615

Interoperability endpoints

  • Direct secure messaging: stephanie.jones@direct.columbusco.nchie.net

Organizations & group practices 1

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": "1550102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1053877084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 JEFFERSON ST",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284723602",
            "telephone_number": "910-640-6615",
            "fax_number": "910-640-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 JEFFERSON ST",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284723602",
            "telephone_number": "910-640-6615",
            "fax_number": "910-640-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "STEPHANIE",
        "middle_name": "TYNER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-14",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5011447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whiteville, NC

Sources for this page

Verify at the official NPI Registry.