Active NPI
Sarra Wildermuth, MSN, RN, ACCNS-AG
- Clinical Nurse Specialist
- Greenville, NC
National Provider Identifier
1124882493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Nurse Specialist
- License
- 609
- Practice address
- 2100 Stantonsburg Rd
Greenville, NC 27834-2818 - Phone
- (252) 816-6367
- NPI assigned
- Feb 7, 2024
- Last updated
- Aug 11, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Nurse Specialist | 364S00000X | 609 | NC | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Registered Nurse | 163W00000X | 0001295447 | VA |
Addresses
Primary practice location
2100 Stantonsburg Rd
Greenville, NC 27834-2818
Mailing address
2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 816-6367
Other practice location 1
1881 University Dr
Virginia Beach, VA 23453-8083
Phone (757) 683-4297
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
- Credentials
- Master of Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0001295447 | VA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754870400000",
"number": "1124882493",
"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": "252-816-6367"
},
{
"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": "252-816-6367"
}
],
"practiceLocations": [
{
"address_1": "1881 University Dr",
"address_purpose": "LOCATION",
"city": "Virginia Beach",
"state": "VA",
"postal_code": "234538083",
"country_code": "US",
"telephone_number": "757-683-4297",
"fax_number": "757-683-5253",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILDERMUTH",
"first_name": "SARRA",
"credential": "MSN, RN, ACCNS-AG",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-07",
"last_updated": "2025-08-11",
"certification_date": "2025-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "364S00000X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist",
"state": "NC",
"license": "609",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "VA",
"license": "0001295447",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Greenville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.