Individual provider Active NPI

Makenzie Whitley, DNP, FNP-C

  • Family Nurse Practitioner
  • Wake Forest, NC
National Provider Identifier
1164378782
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5024066 Issued in NC
Practice address
620 Dr Calvin Jones Hwy Ste 208
Wake Forest, NC 27587-3108
Phone
(984) 204-8801
NPI assigned
Mar 6, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5024066 NC Primary
Nurse Practitioner 363L00000X 5024066 NC

Addresses

Primary practice location

620 Dr Calvin Jones Hwy Ste 208
Wake Forest, NC 27587-3108

Mailing address

11386 Camp Charles Rd
Bailey, NC 27807-8866
Phone (252) 299-3070

Other practice location 1

620 Dr Calvin Jones Hwy Ste 212
Wake Forest, NC 27587-3108
Phone (919) 761-5678

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
I20260331002988 NC Practitioner - Nurse Practitioner 1557846276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Raleigh Durham Medical Group PAGroup PAC ID 2365409588, 80 clinicians

Practice addresses (Care Compare)

620 Dr Calvin Jones Hwy
Suite 212
Wake Forest, NC 27587-3108
Phone (919) 761-5678

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5024066NCMDFamily Nurse Practitioner

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1772755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1164378782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11386 CAMP CHARLES RD",
            "city": "BAILEY",
            "state": "NC",
            "postal_code": "278078866",
            "telephone_number": "252-299-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 DR CALVIN JONES HWY STE 208",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275873108",
            "telephone_number": "984-204-8801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 Dr Calvin Jones Hwy Ste 212",
            "address_purpose": "LOCATION",
            "city": "Wake Forest",
            "state": "NC",
            "postal_code": "275873108",
            "country_code": "US",
            "telephone_number": "919-761-5678",
            "fax_number": "919-761-5680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITLEY",
        "first_name": "MAKENZIE",
        "name_prefix": "Mrs.",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-06",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5024066",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5024066",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

Verify at the official NPI Registry.