Individual provider Active NPI

Carmen Chavez, FNP

  • Family Nurse Practitioner
  • Flat Rock, NC
National Provider Identifier
1174031579
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5010206 Issued in NC
Practice address
571 S Allen Rd
Flat Rock, NC 28731
Phone
(828) 692-6178
Fax
(828) 233-2594
NPI assigned
Jan 19, 2018
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 238483 NC
Family Nurse Practitioner 363LF0000X 5010206 NC Primary

Addresses

Primary practice location

571 S Allen Rd
Flat Rock, NC 28731

Mailing address

571 S Allen Rd
Flat Rock, NC 28731-9447
Phone (286) 926-1788

Other identifiers 2

IdentifierTypeStateIssuer
238483OtherNCRN
5010206OtherNCNURSE PRACTITIONER- FAMILY

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
I20180309001662 NC Practitioner - Nurse Practitioner 8123389061 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pearl Psychedelic InstituteGroup PAC ID 6709314909, 8 clinicians
Hospice of Henderson County IncGroup PAC ID 4880507466, 43 clinicians

Practice addresses (Care Compare)

55 Academy St
Waynesville, NC 28786-3701
Phone (828) 507-1421

571 S Allen Rd
Flat Rock, NC 28731-9447
Phone (828) 692-6178

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5010206NCMDFamily Nurse Practitioner
238483NCMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Hospice of Henderson County, Inc. CurrentSince Feb 5, 2018 Accepting new patients
Hospice of Henderson County Inc CurrentSince Feb 5, 2018 Accepting new patients
Pearl Psychedelic Institute CurrentSince Feb 9, 2025 Accepting new patients

Locations

571 S Allen Rd
Flat Rock, NC 28731
Phone (828) 692-9633

55 Academy St
Waynesville, NC 28786
Phone (828) 246-9751

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1516320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1174031579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 S ALLEN RD",
            "city": "FLAT ROCK",
            "state": "NC",
            "postal_code": "287319447",
            "telephone_number": "286-926-1788",
            "fax_number": "828-233-2594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 S ALLEN RD",
            "city": "FLAT ROCK",
            "state": "NC",
            "postal_code": "28731",
            "telephone_number": "828-692-6178",
            "fax_number": "828-233-2594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "CARMEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-19",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "238483",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5010206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "238483",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER- FAMILY",
            "identifier": "5010206",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flat Rock, NC

Sources for this page

Verify at the official NPI Registry.