Individual provider Active NPI

Cindy A Compeggie

  • Pediatric Nurse Practitioner
  • Jacksonville, NC
National Provider Identifier
1205899713
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
300136 Issued in NC
Practice address
120 Memorial Dr
Jacksonville, NC 28546-6328
Phone
(910) 353-0581
Fax
(910) 353-1351
NPI assigned
Apr 7, 2006
Last updated
Nov 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 300136 NC
Nurse Practitioner 363L00000X 134636 NC
Pediatric Nurse Practitioner 363LP0200X 300136 NC Primary

Addresses

Primary practice location

120 Memorial Dr
Jacksonville, NC 28546-6328

Mailing address

PO Box 986513
Department 100
Boston, MA 02298-6513
Phone (910) 219-8326

Other practice location 1

108 Lakeside Dr
Sneads Ferry, NC 28460-9415
Phone (910) 327-5437

Other practice location 2

118 Memorial Dr
Jacksonville, NC 28546-6328
Phone (910) 353-0581

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
I20210716001314 NC Practitioner - Nurse Practitioner 0648672352 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
134636NCMDNurse Practitioner
300136NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jacksonville Children's and Multispecialty Clinic, PA CurrentSince Jun 28, 2021 Accepting new patients
Amm Healthcare, PA CurrentSince May 22, 2022 Accepting new patients
Jacksonville Behavior and Mental Health CurrentSince Jun 28, 2021 Accepting new patients
Family Care Clinic, P.a. Past Accepting new patients
Carolina Pediatrics Past Accepting new patients

Locations

114C Memorial Dr
Jacksonville, NC 28546
Phone (910) 346-3976

118 Memorial Dr
Jacksonville, NC 28546
Phone (910) 353-0581

120 Memorial Dr
Jacksonville, NC 28546
Phone (910) 353-0581

108 Lakeside Dr
Sneads Ferry, NC 28460
Phone (910) 327-5437

Interoperability endpoints

  • Direct secure messaging: ccompeggie@carteretclinic.opdirect.net
  • FHIR API: https://api.platform.athenahealth.com/4693/brand/6/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1205899713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 986513",
            "address_2": "DEPARTMENT 100",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022986513",
            "telephone_number": "910-219-8326",
            "fax_number": "910-939-4269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MEMORIAL DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466328",
            "telephone_number": "910-353-0581",
            "fax_number": "910-353-1351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 Lakeside Dr",
            "address_purpose": "LOCATION",
            "city": "Sneads Ferry",
            "state": "NC",
            "postal_code": "284609415",
            "country_code": "US",
            "telephone_number": "910-327-5437",
            "fax_number": "910-327-5436",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "118 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285466328",
            "country_code": "US",
            "telephone_number": "910-353-0581",
            "fax_number": "910-577-1150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COMPEGGIE",
        "first_name": "CINDY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-07",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "300136",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "134636",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "300136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.