Individual provider Active NPI

Carrie Amici Tingley, AGNP-C

  • Adult Health Nurse Practitioner
  • Washington, NC
National Provider Identifier
1205201647
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
5008243 Issued in NC
Practice address
1380 Cowell Farm Rd
Washington, NC 27889-3431
Phone
(252) 946-2101
Fax
(252) 946-9896
NPI assigned
Dec 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 5008243 NC Primary

Addresses

Primary practice location

1380 Cowell Farm Rd
Washington, NC 27889-3431

Mailing address

1380 Cowell Farm Rd
Washington, NC 27889-3431
Phone (252) 946-2101

Other identifiers 1

IdentifierTypeStateIssuer
5008243OtherNCNC STATE LICENSE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address camicigood95011@direct.vidanthealth.com
Direct Messaging Address camicigood95011@direct.vidanthealth.com

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
I20160310002053 NC Practitioner - Nurse Practitioner 6709182199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

608 E 12TH St
Vidant Multispecialty Clinic Washiington
Washington, NC 27889-3409
Phone (252) 974-7500

Hospital & facility affiliations

  • Gentiva Health Services Home health agency, Washington, NC, CCN 347329
  • Ecu Health Medical Center Hospital, Greenville, NC, CCN 340040

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5008243NCMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Sep 4, 2018 Accepting new patients
Vidant Medical Group LLC CurrentSince Sep 4, 2018 Accepting new patients

Locations

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

600 Moye Blvd
Greenville, NC 27834
Phone (252) 744-1111

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

608 E 12th St
Washington, NC 27889
Phone (252) 758-3211

1380 Cowell Farm Rd
Washington, NC 27889
Phone (252) 946-0900

Organizations & group practices 2

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 3

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": "1449705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1205201647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 COWELL FARM RD",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893431",
            "telephone_number": "252-946-2101",
            "fax_number": "252-946-9896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 COWELL FARM RD",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893431",
            "telephone_number": "252-946-2101",
            "fax_number": "252-946-9896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINGLEY",
        "first_name": "CARRIE",
        "middle_name": "AMICI",
        "name_prefix": "Mrs.",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-10",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5008243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC STATE LICENSE",
            "identifier": "5008243",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "camicigood95011@direct.vidanthealth.com",
            "affiliation": "N",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342818",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "camicigood95011@direct.vidanthealth.com",
            "affiliation": "N",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Washington, NC

Sources for this page

Verify at the official NPI Registry.