Phyllis C Averett, NP
Individual provider Active NPI Nurse Practitioner · Oxford, NC
NPI 1124337571 · NPPES record last updated Jul 8, 2013
Key facts
- NPI
- 1124337571
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 5004902 (NC)
- Practice address
- 102 Professional Park
#A
Oxford, NC 27565-2501 - Phone
- (919) 603-1665
- Fax
- (919) 603-0143
- NPI assigned
- Oct 4, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- University of Colorado School of Medicine, Denver, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Granville Health System
Practice addresses (Care Compare)
1010 College St
Oxford, NC 27565-2507
Phone (919) 690-3237
Hospital & facility affiliations
- Granville Health Systems
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101109001243 | NC | Practitioner - Nurse Practitioner | 8325233976 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5004902 | NC | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Granville Health System | Current |
Accepting new patients | |
| Granville Health System | Current | Accepting new patients | |
| Granville Health System | Current | Accepting new patients | |
| Granville Health System | Current |
Accepting new patients | |
| Cardiovascular Care of Northern Carolina PA | Past | Accepting new patients | |
| Unc Physicians Network LLC | Past | Accepting new patients |
Locations
110 Professional Park
Oxford, NC 27565
Phone (919) 693-6541
102 Professional Park
Ste A
Oxford, NC 27565
Phone (919) 603-1665
1010 College St
Oxford, NC 27565
Phone (919) 623-5115
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 5004902 | NC | Yes |
Addresses
Primary practice location
102 Professional Park
#A
Oxford, NC 27565-2501
Mailing address
1600 Perimeter Park Dr
Suite 225
Morrisville, NC 27560-8421
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7005295 | Medicaid | NC |
Other providers in Oxford, NC
- Amanda Marie Aquilino
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- Asis Counseling, PLLC
- Assurance and Quality Care LLC
- At Home Counseling Services
- Dwight M Ayscue
- Jennifer Lynn Bailess
- Bridgit Lashea Bailey
- Jennifer Kristen Ball
- Bart Leigh Cleary
All providers in Oxford, NC · Nurse Practitioner in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.