NPIMap

Individual provider Active NPI

Bonnie Jean Willoughby, FNP-C

  • Nurse Practitioner
  • Lumberton, NC
National Provider Identifier
1184118135
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5010638 Issued in NC
Practice address
404 Hatfield CT
Lumberton, NC 28358
Phone
(910) 738-3358
Fax
(910) 738-9174
NPI assigned
Jun 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5010638 NC Primary

Addresses

Primary practice location

404 Hatfield CT
Lumberton, NC 28358

Mailing address

404 Hatfield CT
Lumberton, NC 28358-1126
Phone (910) 738-3358

Other names 1

  • Miss Bonnie Willoughby Skiadiotis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190306000576 NC Practitioner - Nurse Practitioner 7416296694 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Eventus Wholehealth PLLCGroup PAC ID 6002169539, 301 clinicians

Practice addresses (Care Compare)

101 Cabarrus Ave E
Suite 200
Concord, NC 28025-3781
Phone (855) 743-2247

Hospital & facility affiliations

  • Amedisys Home Health of Fayetteville Home health agency, Fayetteville, NC, CCN 347132
  • Cape Fear Valley Medical Center Hospital, Fayetteville, NC, CCN 340028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5010638NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Timothy Turbett MD PC Nurse Practitioner CurrentSince Mar 26, 2024 Accepting new patients
Eventus WH Southeast, LLC Nurse Practitioner CurrentSince Jan 1, 2025 Accepting new patients
Allen Orthopedics P a CurrentSince Mar 1, 2019 Accepting new patients
Eventus Value Care, LLC CurrentSince Oct 21, 2025 Accepting new patients
Eventus Wholehealth Aco LLC Nurse Practitioner CurrentSince Aug 1, 2024 Accepting new patients
Eventus WH PLLC Care, LLC CurrentSince Sep 1, 2025 Accepting new patients
Physiatry Consultants of NC PLLC CurrentSince Jun 1, 2023 Accepting new patients
Eventus Wholehealth, PLLC Nurse Practitioner CurrentSince Aug 1, 2024 Accepting new patients

Locations

415 W Golf Rd
Ste 26
Arlington Hts, IL 60005

1 Pond St
Arden, NC 28704
Phone 82877452220027

211 Milton Brown Heirs Rd
Boone, NC 28607
Phone (828) 264-6720

2810 Coliseum Centre Dr
Ste 120
Charlotte, NC 28217

212 S Tryon St
Ste 1000
Charlotte, NC 28281
Phone (512) 575-8028

1601 Purdue Dr
Fayetteville, NC 28304
Phone (910) 486-5000

404 Hatfield Ct
Lumberton, NC 28358
Phone (910) 738-3358

160 Mine Lake Ct
#200
Raleigh, NC 27615
Phone (404) 805-4288

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/0006195
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 8

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.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1184118135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 HATFIELD CT",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283581126",
            "telephone_number": "910-738-3358",
            "fax_number": "910-738-9174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 HATFIELD CT",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "28358",
            "telephone_number": "910-738-3358",
            "fax_number": "910-738-9174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLOUGHBY",
        "first_name": "BONNIE",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-21",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5010638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BONNIE",
            "last_name": "SKIADIOTIS",
            "middle_name": "WILLOUGHBY",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lumberton, NC

Sources for this page

Verify at the official NPI Registry.