Kimball Jane-Marie Sargent, MSN, PMHCNS-BC

Primary specialty

Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X

License

0261495-01 Issued in NC

Practice address

7155 Sunset Lake Rd
Fuquay Varina, NC 27526-8638

Phone

(919) 838-0804

Fax

(919) 838-1219

NPI assigned

May 28, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 5

Other names 1

• Ms. Jane Marie Sargent-Trollinger Former name

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

Specialty

Certified Clinical Nurse Specialist (CNS)

Education

University of North Carolina at Chapel Hill School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Master of Science - Nursing

State licenses

Practice roles

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.

• Diverse Wellness Solutions Inc

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Fuquay Varina, NC
  • NPI 1912299173

  Multi-Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547337600000",
    "number": "1174570808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7155 SUNSET LAKE RD",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275268638",
            "telephone_number": "919-838-0804",
            "fax_number": "919-838-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7155 SUNSET LAKE RD",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275268638",
            "telephone_number": "919-838-0804",
            "fax_number": "919-838-1219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARGENT",
        "first_name": "KIMBALL",
        "middle_name": "JANE-MARIE",
        "name_prefix": "Mrs.",
        "credential": "MSN, PMHCNS-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-28",
        "last_updated": "2019-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "080028",
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "NC",
            "license": "080028",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "NC",
            "license": "0261495-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "10079",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS MHS #",
            "identifier": "527619",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6004025",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPSYCH CORP. PROV #",
            "identifier": "232289",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDAMER.INS.CO. PROV #",
            "identifier": "C 2802004",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANE",
            "last_name": "SARGENT-TROLLINGER",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "MSN, RN, CS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michelle L Sall, OD
• Priyanka Sampat, PT
• Katrinna Anthony Sampson, MA CCC-SLP
• Lana Sampson, MS, PH.D.
• Morgan Sands
• Nicole Sargent, LCSWA
• Isabella Sauls
• Joanne Scannell
• Angie Renee Schmidt, FNP
• Kevin W Schmidtke, D.P.M.

• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Fuquay Varina, NC
• Providers in Fuquay Varina, NC by specialty
• Adult Psychiatric/Mental Health Clinical Nurse Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.