Individual provider Active NPI

Nadiah Mahmoud, FNP

  • Family Nurse Practitioner
  • Winterville, NC
National Provider Identifier
1134900236
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
267129 Issued in NC
Practice address
324A Beacon Dr
Winterville, NC 28590-7956
Phone
(252) 551-5595
Fax
(252) 324-7762
NPI assigned
Oct 13, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 267129 NC Primary

Addresses

Primary practice location

324A Beacon Dr
Winterville, NC 28590-7956

Mailing address

324A Beacon Dr
Winterville, NC 28590-7956
Phone (252) 551-5595

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
I20240307001391 NC Practitioner - Nurse Practitioner 5092151563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wintergreen Medical Center PLLCGroup PAC ID 2365539582, 2 clinicians

Practice addresses (Care Compare)

324 A Beacon Dr
Winterville, NC 28590-7956
Phone (252) 551-5595

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
267129NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wintergreen Medical Center, PLLC CurrentSince Jan 15, 2025 Accepting new patients

Locations

324A Beacon Dr
Winterville, NC 28590
Phone (252) 551-5595

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BFAEAA/Endpoint/BFAEAA

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1697155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1134900236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324A BEACON DR",
            "city": "WINTERVILLE",
            "state": "NC",
            "postal_code": "285907956",
            "telephone_number": "252-551-5595",
            "fax_number": "252-321-7762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324A BEACON DR",
            "city": "WINTERVILLE",
            "state": "NC",
            "postal_code": "285907956",
            "telephone_number": "252-551-5595",
            "fax_number": "252-324-7762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHMOUD",
        "first_name": "NADIAH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-13",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "267129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winterville, NC

Sources for this page

Verify at the official NPI Registry.