Active NPI
North Carolina Nephrology PA
- Nephrology Physician
- Smithfield, NC
National Provider Identifier
1134623002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- Legal business name
- NORTH CAROLINA NEPHROLOGY PA
- Practice address
- 1559 E Booker Dairy Rd Ste B
Smithfield, NC 27577-9442 - Phone
- (919) 876-7807
- Fax
- (919) 876-8823
- NPI assigned
- Mar 23, 2018
- Last updated
- Sep 19, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jennifer Capps
- Title
- Billing Manager
- Phone
- (919) 231-3966
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | NU | Primary |
Addresses
Primary practice location
1559 E Booker Dairy Rd Ste B
Smithfield, NC 27577-9442
Mailing address
3700 Barrett Dr Ste 200
Raleigh, NC 27609-7213
Phone (919) 231-3966
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170103000254 | NC | Part B Supplier - Clinic/Group Practice | 0244511483 |
Receives reassigned benefits from 68 practitioners 9 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Raleigh, NC; Wilson, NC; Wake Forest, NC; Smithfield, NC; Louisburg, NC; Fuquay Varina, NC; Dunn, NC; Cary, NC |
Other NPIs on the same Medicare enrollment 6
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Tax ID family
- North Carolina Nephrology PA
Other organizations with this tax ID 4
Organizations that report the same tax identification number in the National Provider Directory.
-
- Nephrology Physician
- Dunn, NC
- NPI 1053815993
-
- Nephrology Physician
- Fuquay Varina, NC
- NPI 1558865402
-
- Nephrology Physician
- Cary, NC
- NPI 1811492663
-
- Nephrology Physician
- Wake Forest, NC
- NPI 1932603800
Locations
3031 New Bern Ave
Ste 306
Raleigh, NC 27610
Phone (919) 459-8409
1559 E Booker Dairy Rd
Ste B
Smithfield, NC 27577
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Nephrology Physician
- Cary, NC
- NPI 1861669681
-
- Physician Assistant
- Raleigh, NC
- NPI 1689612442
-
- Physician Assistant
- Raleigh, NC
- NPI 1669802880
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521763200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1726704000000",
"number": "1134623002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3700 BARRETT DR STE 200",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276097213",
"telephone_number": "919-231-3966",
"fax_number": "919-231-3912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1559 E BOOKER DAIRY RD STE B",
"city": "SMITHFIELD",
"state": "NC",
"postal_code": "275779442",
"telephone_number": "919-876-7807",
"fax_number": "919-876-8823"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTH CAROLINA NEPHROLOGY PA",
"organizational_subpart": "NO",
"enumeration_date": "2018-03-23",
"last_updated": "2024-09-19",
"certification_date": "2024-09-19",
"status": "A",
"authorized_official_last_name": "CAPPS",
"authorized_official_first_name": "JENNIFER",
"authorized_official_title_or_position": "BILLING MANAGER",
"authorized_official_telephone_number": "919-231-3966"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Smithfield, NC
- Patricia Renee Nichols, PTA
- Nitelite Pediatric Urgent Care
- Nitelite Pediatric Urgent Care, PA
- Ashley Green Nordan, PA
- North Carolina CVS Pharmacy LLC (CVS Pharmacy #07580)
- Bliss Davis Norville, FNP
- Nova Urgent & Medical Care, P.a.
- Nutrition Solutions Group
- Emily Rose O'Brien, MOT
- James Allen Oldham IV, DDS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.