Individual provider Active NPI

Stephanie Mills Wynn, RN, MSN, FNP-C

  • Family Nurse Practitioner
  • Washington, NC
National Provider Identifier
1063765345
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5005890 Issued in NC
Practice address
2005 W 15TH St
Washington, NC 27889-3591
Phone
(252) 833-5245
Fax
(252) 833-5244
NPI assigned
Oct 24, 2012
Last updated
Jun 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5005890 NC
Family Nurse Practitioner 363LF0000X 5005890 NC Primary

Addresses

Primary practice location

2005 W 15TH St
Washington, NC 27889-3591

Mailing address

2005 W 15TH St
Washington, NC 27889-3591
Phone (252) 833-5245

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
I20130205000427 NC Practitioner - Nurse Practitioner 2668626375 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians
Healthfirst Wellness CenterGroup PAC ID 7315468162, 3 clinicians

Practice addresses (Care Compare)

101 Clinic Dr
Tarboro, NC 27886-1935
Phone (252) 823-2105

401 A N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

401 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

417 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-8080

501 N Main St
Robersonville, NC 27871-9567
Phone (252) 341-5811

598 W Old County Rd
Belhaven, NC 27810-1232
Phone (252) 943-0600

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Nov 24, 2020 Accepting new patients
Vidant Medical Group LLC CurrentSince Nov 24, 2020 Accepting new patients
Thrivewell Health and Wellness PLLC Family Current Accepting new patients
Healthfirst Wellness Center, PLLC Family CurrentSince Nov 1, 2024 Accepting new patients
Williamston Clinic Corp Nurse Practitioner CurrentSince Sep 1, 2020 Accepting new patients
East Carolina Health - Heritage Inc CurrentSince Nov 19, 2023 Accepting new patients
Carolina Quickcare Family Practice, PLLC CurrentSince Jan 30, 2023 Accepting new patients
Williamston Hospital Corporation PastSince Mar 9, 2020 Accepting new patients

Locations

2265 NC Highway 24 27 E
Biscoe, NC 27209
Phone (919) 810-0054

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

1473 NC 42 43 W
Pinetops, NC 27864
Phone (252) 641-8585

501 N Main St
Robersonville, NC 27871
Phone (252) 284-3501

4612 Main St
Shallotte, NC 28470
Phone (910) 444-2970

101 Clinic Dr
Tarboro, NC 27886
Phone (252) 823-2105

2005 W 15th St
Washington, NC 27889

104 Medical Dr
Williamston, NC 27892
Phone (252) 809-6300

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EHGJDD/Endpoint/EHGJDD
  • Direct secure messaging: sellis45056@direct.ecuhealth.com
  • Direct secure messaging: stephanie.wynn.1@32322.direct.athenahealth.com

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": "1351036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1063765345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 W 15TH ST",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893591",
            "telephone_number": "252-833-5245",
            "fax_number": "252-833-5244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 W 15TH ST",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893591",
            "telephone_number": "252-833-5245",
            "fax_number": "252-833-5244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "STEPHANIE",
        "middle_name": "MILLS",
        "credential": "RN, MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-24",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5005890",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5005890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, NC

Sources for this page

Verify at the official NPI Registry.