Individual provider Active NPI

Eva Foegeding Squibb, FNP-BC

  • Family Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1073092417
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5010830 Issued in NC
Practice address
801 E 4TH St
Charlotte, NC 28202-2808
Phone
(980) 314-5463
NPI assigned
Aug 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

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 5010830 NC Primary

Addresses

Primary practice location

801 E 4TH St
Charlotte, NC 28202-2808

Mailing address

11807 Painted Tree Rd
Charlotte, NC 28226-3845
Phone (919) 606-2685

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5010830NCMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1073092417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11807 PAINTED TREE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282263845",
            "telephone_number": "919-606-2685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E 4TH ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022808",
            "telephone_number": "980-314-5463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SQUIBB",
        "first_name": "EVA",
        "middle_name": "FOEGEDING",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5010830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.