Jeffrey Wayne Autry, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

105149 Issued in NC

Practice address

1004 Beamon St.
Clinton, NC 28328-0227

Phone

(910) 592-9113

Fax

(910) 590-0050

NPI assigned

Apr 3, 2006

Last updated

Nov 21, 2007By the provider in NPPES

Sex

Male

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 2

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, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wallace Urgent Care LLCGroup PAC ID 6709967912, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Wallace Urgent Care LLC

  • Internal Medicine Physician
  • Wallace, NC
  • NPI 1841259025

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Sampson Regional Professional Services LLC

  dba Sampson Family Medicine

  • Family Medicine Physician
  • Clinton, NC
  • NPI 1730311648
  Medicare reassignment NPD
• Urgent Care of Wallace, PLLC

  • Urgent Care Clinic/Center
  • Wallace, NC
  • NPI 1699372243
  Medicare reassignment NPD
• Sampson Regional Professional Services LLC

  dba Clinton Urgent Care

  • Family Medicine Physician
  • Clinton, NC
  • NPI 1710209234
  NPD
• Sampson Regional Professional Services, LLC

  dba Sampson Surgical Services

  • Surgery Physician
  • Clinton, NC
  • NPI 1760744361
  NPD
• Penslow Health Clinic Inc

  dba Penslow Medical Center

  • Rural Health Clinic/Center
  • Holly Ridge, NC
  • NPI 1093813842
  NPD (past)

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195603200000",
    "number": "1063474559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 BEAMON ST.",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283280227",
            "telephone_number": "910-592-9113",
            "fax_number": "910-590-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 BEAMON ST.",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283280227",
            "telephone_number": "910-592-9113",
            "fax_number": "910-590-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUTRY",
        "first_name": "JEFFREY",
        "middle_name": "WAYNE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2007-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "105149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NO",
            "identifier": "2344540",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIV PROVIDER",
            "identifier": "2806457A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Assured Care
• Atlantic Hospitalists Physicians, LLP
• Atlantis Counseling Services, P.C.
• Scott D Augustine, MD
• Janice Austria
• Lauren Elaine Aves, CPNP-PC
• Danny Wayne Aycock, RPH
• Leah Palmer Aycock, PT, DPT
• Melanie Barber, PHARM.D
• Jeremy Wayne Barefoot, PHARMD

• Nurse Practitioner in Clinton, NC
• Providers in Clinton, 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 Nov 21, 2007; 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.