Individual provider Active NPI

Benessa Mitchell Sutton, AGNP-C

  • Gerontology Nurse Practitioner
  • Greenville, NC
National Provider Identifier
1124679683
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
5012331 Issued in NC
Practice address
2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone
(252) 847-4100
NPI assigned
Sep 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 5012331 NC Primary

Addresses

Primary practice location

2100 Stantonsburg Rd
Greenville, NC 27834-2818

Mailing address

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 847-4100

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
I20191122000003 NC Practitioner - Nurse Practitioner 8224460720 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Opportunities Industrialization Center, IncGroup PAC ID 3173563590, 9 clinicians

Practice addresses (Care Compare)

111 S Fairview Rd
Rocky Mount, NC 27801-6971
Phone (252) 212-3486

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Wilson Physician Practices LLC Nurse Practitioner CurrentSince May 17, 2021 Accepting new patients
Vidant Medical Group LLC CurrentSince Oct 31, 2019 Accepting new patients
Opportunities Industrialization Center, Inc CurrentSince May 20, 2024 Accepting new patients
DLP Wilson Physician Practices LLC CurrentSince May 17, 2021 Accepting new patients
Vidant Medical Group LLC CurrentSince Oct 31, 2019 Accepting new patients
Opportunities Industrialization Center, Inc CurrentSince May 20, 2024 Accepting new patients
Opportunities Industrialization Center, Inc Past Accepting new patients

Locations

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

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

2309 Sunset Ave
Rocky Mount, NC 27804
Phone (252) 210-9856

2605 Forest Hills Rd SW
Ste A
Wilson, NC 27893
Phone (252) 243-0043

1700 Tarboro St W
Ste 200
Wilson, NC 27893
Phone (252) 399-5310

Organizations & group practices 11

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": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1124679683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 STANTONSBURG RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278342818",
            "telephone_number": "252-847-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 STANTONSBURG RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278342818",
            "telephone_number": "252-847-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "BENESSA",
        "middle_name": "MITCHELL",
        "name_prefix": "Mrs.",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-26",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NC",
            "license": "5012331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.