Individual provider Active NPI

Terra Lynn Kamp, NP-C

  • Nurse Practitioner
  • Jacksonville, NC
National Provider Identifier
1083079701
Registry record updated Sep 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5009904 Issued in NC
Practice address
1715 Country Club Rd Ste B
Jacksonville, NC 28546-6042
Phone
(910) 238-2050
NPI assigned
Dec 22, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5009904 NC
Nurse Practitioner 363L00000X 5009904 NC Primary

Addresses

Primary practice location

1715 Country Club Rd Ste B
Jacksonville, NC 28546-6042

Mailing address

1715 Country Club Rd Ste B
Jacksonville, NC 28546-6042
Phone (910) 238-2050

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
I20171221000828 NC Practitioner - Nurse Practitioner 9436417441 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Headache Clinic PLLCGroup PAC ID 9436536547, 3 clinicians

Practice addresses (Care Compare)

1715 Country Club Rd
Jacksonville, NC 28546-6042
Phone (910) 238-2050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5009904NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rapha Wound Care PLLC Nurse Practitioner CurrentSince Dec 15, 2024 Accepting new patients
Coastal Headache Clinic PLLC Nurse Practitioner CurrentSince Apr 1, 2022 Accepting new patients

Locations

1715 Country Club Rd
Ste B
Jacksonville, NC 28546
Phone (910) 238-2050

935 E Mountain St
Ste M
Kernersville, NC 27284
Phone (336) 310-4712

Interoperability endpoints

  • Direct secure messaging: coastalheadacheclinic.terrakamp@152605.advancedmd-direct.com

Organizations & group practices 2

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": "1450742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1083079701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 COUNTRY CLUB RD STE B",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466042",
            "telephone_number": "910-238-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 COUNTRY CLUB RD STE B",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466042",
            "telephone_number": "910-238-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMP",
        "first_name": "TERRA",
        "middle_name": "LYNN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-22",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5009904",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5009904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.