NPIMap

Individual provider Active NPI

Elizabeth Renee Prevette, ANP-BC, DACHM

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1184642415
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5021705 Issued in NC
Practice address
6324 Fairview Rd Ste 310
Charlotte, NC 28210-4172
Phone
(980) 302-8680
Fax
(980) 302-8681
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP2416 AZ
Nurse Practitioner 363L00000X 5021705 NC Primary

Addresses

Primary practice location

6324 Fairview Rd Ste 310
Charlotte, NC 28210-4172

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

1705 W Main St
Mesa, AZ 85201-6920
Phone (480) 964-2273

Other identifiers 1

IdentifierTypeStateIssuer
119371MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060927000607 AZ Practitioner - Nurse Practitioner 1456356344 Reassigns benefits to 3 organizations
I20250310003268 NC Practitioner - Nurse Practitioner 1456356344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

10810 Mallard Creek Rd
Charlotte, NC 28262-9786
Phone (704) 510-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5021705NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc CurrentSince Jan 1, 2010 Accepting new patients
Arizona Acute Medical Services 1 PC CurrentSince Feb 1, 2024 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Feb 19, 2025 Accepting new patients
Adelante Healthcare, Inc CurrentSince Feb 26, 2024 Accepting new patients
Adelante Healthcare, Inc. Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Feb 19, 2025 Accepting new patients
District Medical Group, Inc CurrentSince Jan 1, 2010 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Adelante Healthcare, Inc. CurrentSince Feb 26, 2024 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

18701 N 67th Ave
Glendale, AZ 85308
Phone (623) 561-1000

13471 W Cornerstone Blvd
Goodyear, AZ 85395

1705 W Main St
Mesa, AZ 85201
Phone (480) 845-6769

2525 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 344-1015

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

1930 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 532-1000

3141 N 3rd Ave
Ste 100
Phoenix, AZ 85013
Phone (602) 914-1520

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

3929 E Bell Rd
Phoenix, AZ 85032
Phone (602) 923-5000

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

3033 N Central Ave
Ste 145
Phoenix, AZ 85012

15317 W Bell Rd
Ste 100
Surprise, AZ 85374

1918 Randolph Rd
Ste 400
Charlotte, NC 28207
Phone (704) 384-9437

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

6324 Fairview Rd
Ste 310
Charlotte, NC 28210
Phone (704) 316-6565

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

190 Kimel Park Dr
Ste 120
Winston Salem, NC 27103
Phone (336) 277-2200

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: eprevette1670029@direct.novanthealth.org

Organizations & group practices 10

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 9

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1184642415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6324 FAIRVIEW RD STE 310",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282104172",
            "telephone_number": "980-302-8680",
            "fax_number": "980-302-8681"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1705 W Main St",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852016920",
            "country_code": "US",
            "telephone_number": "480-964-2273",
            "fax_number": "480-718-9477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PREVETTE",
        "first_name": "ELIZABETH",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "ANP-BC, DACHM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP2416",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5021705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119371",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.