Individual provider Active NPI

Annmarie V Earnhardt, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Durham, NC
National Provider Identifier
1164063566
Registry record updated Oct 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5012286 Issued in NC
Practice address
508 Fulton St
Durham, NC 27705-3875
Phone
(919) 286-0411
NPI assigned
Oct 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5012286 NC Primary

Addresses

Primary practice location

508 Fulton St
Durham, NC 27705-3875

Mailing address

1200 Neisler Rd
Concord, NC 28025-6705
Phone (919) 698-0012

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

State licenses

LicenseStateTypeSpecialty
5012286NCMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1570406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1164063566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 NEISLER RD",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280256705",
            "telephone_number": "919-698-0012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 FULTON ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053875",
            "telephone_number": "919-286-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARNHARDT",
        "first_name": "ANNMARIE",
        "middle_name": "V",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-07",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5012286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.