Individual provider Active NPI

Debra Ann Warndahl, MSN, NNP-BC, ARNP

  • Neonatal Nurse Practitioner
  • Winston Salem, NC
National Provider Identifier
1063465532
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
209014375 Issued in IL
Practice address
3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone
(336) 718-3278
NPI assigned
May 18, 2006
Last updated
Jul 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 5018082 NC
Neonatal Nurse Practitioner 363LN0000X ARNP2004582 FL
Neonatal Nurse Practitioner 363LN0000X 209014375 IL Primary
Critical Care Neonatal Nurse Practitioner 363LN0005X ARNP2004582 FL

Addresses

Primary practice location

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013

Mailing address

205 Shepherds Bluff Dr
Mooresville, NC 28115-7184
Phone (813) 417-1708

Other practice location 1

2817 Rock Merritt Ave
Fort Liberty, NC 28310-4804
Phone (910) 907-7626

Other practice location 2

124 SW Adams St
Peoria, IL 61602-1308
Phone (309) 308-6785

Other identifiers 2

IdentifierTypeStateIssuer
Y0ES0OtherFLBLUE CROSS BLUE SHIELD
308355100MedicaidFL

Other names 1

  • Debra Ann Harwood-Warndahl Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210712003776 IL Practitioner - Nurse Practitioner 4981006061 Reassigns benefits to 2 organizations
I20250221000975 NC Practitioner - Nurse Practitioner 4981006061 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP2004582FLMDNeonatal Nurse Practitioner
5018082NCMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Frye Medical Group LLC CurrentSince Mar 1, 2025 Accepting new patients
Osf Healthcare System CurrentSince Jul 1, 2021 Accepting new patients
DLP Frye Medical Group LLC Neonatal CurrentSince Mar 1, 2025 Accepting new patients
Osf Healthcare System CurrentSince Jul 1, 2021 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Healthcare System Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Sep 1, 2021 Accepting new patients
Trinity Medical Center Past Accepting new patients

Locations

2850 W 95th St
Evergreen Pk, IL 60805
Phone (708) 422-2242

500 John Deere Rd
Moline, IL 61265
Phone (309) 779-2840

1000 W Harlem Ave
Monmouth, IL 61462
Phone (309) 734-1414

124 SW Adams St
Peoria, IL 61602
Phone (309) 655-2850

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

415 N Center St
Hickory, NC 28601
Phone (828) 323-8281

915 Tate Blvd SE
Ste 182
Hickory, NC 28602
Phone (828) 322-2005

915 Tate Blvd SE
Ste 186
Hickory, NC 28602
Phone (828) 449-8458

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • Direct secure messaging: dwarndahl1137671@direct.novanthealth.org

Organizations & group practices 8

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1063465532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 SHEPHERDS BLUFF DR",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281157184",
            "telephone_number": "813-417-1708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 SILAS CREEK PKWY",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033013",
            "telephone_number": "336-718-3278"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2817 Rock Merritt Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Liberty",
            "state": "NC",
            "postal_code": "283104804",
            "country_code": "US",
            "telephone_number": "910-907-7626",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "124 SW Adams St",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616021308",
            "country_code": "US",
            "telephone_number": "309-308-6785",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARNDAHL",
        "first_name": "DEBRA",
        "middle_name": "ANN",
        "credential": "MSN, NNP-BC, ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "NC",
            "license": "5018082",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "FL",
            "license": "ARNP2004582",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "IL",
            "license": "209014375",
            "primary": true
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "FL",
            "license": "ARNP2004582",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Y0ES0",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "308355100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "HARWOOD-WARNDAHL",
            "middle_name": "ANN",
            "credential": "MSN, NNP,  ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.