Individual provider Active NPI

Brittany Evans Jackson, FNP-C

  • Family Nurse Practitioner
  • Smithfield, NC
National Provider Identifier
1073375648
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5019508 Issued in NC
Practice address
514 N Brightleaf Blvd Ste 1100
Smithfield, NC 27577-4487
Phone
(919) 989-2192
Fax
(919) 934-0006
NPI assigned
Jan 29, 2024
Last updated
Oct 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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 5019508 NC Primary

Addresses

Primary practice location

514 N Brightleaf Blvd Ste 1100
Smithfield, NC 27577-4487

Mailing address

4171 Hockaday Rd
Four Oaks, NC 27524-7240
Phone (919) 901-2931

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
I20240307002975 NC Practitioner - Nurse Practitioner 3476999889 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

509 N Brightleaf Blvd
Smithfield, NC 27577-4407
Phone (919) 938-7595

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5019508NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Universal Health Corporation CurrentSince Feb 20, 2024 Accepting new patients
Johnston Specialty Physician Services,Inc CurrentSince Oct 8, 2024 Accepting new patients
Johnston Specialty Physician Services,Inc Current Accepting new patients
Carolina Quickcare Family Practice, PLLC CurrentSince Jan 25, 2024 Accepting new patients
Johnston Specialty Physician Services,Inc Past Accepting new patients

Locations

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

1987 Hilton Rd
Burlington, NC 27217
Phone (336) 226-0848

1106 Sunset Ave
Clinton, NC 28328
Phone (919) 648-4847

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

509 N Brightleaf Blvd
Smithfield, NC 27577
Phone (919) 934-8171

514 N Brightleaf Blvd
Ste 1100
Smithfield, NC 27577
Phone (919) 939-2192

Interoperability endpoints

  • Direct secure messaging: bjackson489788@direct.medicine.duke.edu

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1073375648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4171 HOCKADAY RD",
            "city": "FOUR OAKS",
            "state": "NC",
            "postal_code": "275247240",
            "telephone_number": "919-901-2931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 N BRIGHTLEAF BLVD STE 1100",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275774487",
            "telephone_number": "919-989-2192",
            "fax_number": "919-934-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BRITTANY",
        "middle_name": "EVANS",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5019508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithfield, NC

Sources for this page

Verify at the official NPI Registry.