Individual provider Active NPI

Sandra M Parks, FNP-BC

  • Family Nurse Practitioner
  • Greenville, NC
National Provider Identifier
1063573129
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
940023 Issued in NC
Practice address
201 Government Cir
Greenville, NC 27834-8198
Phone
(252) 902-2305
Fax
(252) 413-1433
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 940023 NC Primary

Addresses

Primary practice location

201 Government Cir
Greenville, NC 27834-8198

Mailing address

3003 Phillips Rd
Greenville, NC 27834-4931
Phone (252) 321-7457

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
I20160215000069 NC Practitioner - Nurse Practitioner 1153625033 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Family Services PLLCGroup PAC ID 2567464563, 7 clinicians

Practice addresses (Care Compare)

202 NC Hwy 42 W
Ahoskie, NC 27910-9743
Phone (252) 439-0700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
940023NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Pitt Office of Auditor CurrentSince Aug 1, 2016 Accepting new patients
Carolina Clinic for Health and Wellness PA CurrentSince Nov 30, 2015 Accepting new patients
Integrated Family Services PLLC CurrentSince Feb 21, 2023 Accepting new patients
Integrated Family Services PLLC CurrentSince Feb 21, 2023 Accepting new patients

Locations

202 NC Highway 42 W
Ahoskie, NC 27910
Phone (252) 332-5917

3001 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 347-8642

201 Government Cir
Greenville, NC 27834
Phone (252) 902-2305

2459 Emerald Pl
Ste 102
Greenville, NC 27834
Phone (252) 695-0424

Organizations & group practices 4

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063573129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 PHILLIPS RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278344931",
            "telephone_number": "252-321-7457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 GOVERNMENT CIR",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278348198",
            "telephone_number": "252-902-2305",
            "fax_number": "252-413-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "SANDRA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "940023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.