Jessica Nicole Wilburn, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5011633 Issued in NC

Practice address

515 W Salisbury St Ste D
Asheboro, NC 27203-5498

Phone

(336) 636-5100

Fax

(336) 636-5144

NPI assigned

Apr 9, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jessica Nicole Williams 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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Summit Family Medicine

  • Family Medicine Physician
  • Asheboro, NC
  • NPI 1316128580
  NPD

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1225591118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8222 HIGH PINE CHURCH RD",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272058530",
            "telephone_number": "336-460-0536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 W SALISBURY ST STE D",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272035498",
            "telephone_number": "336-636-5100",
            "fax_number": "336-636-5144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBURN",
        "first_name": "JESSICA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-09",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5011633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "WILLIAMS",
            "middle_name": "NICOLE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• White Oak Family Physicians, PA
• Dana Elizabeth White, LCAS-A
• Hans Jurgen White, PA
• Thomas M. Whyte, M.D.
• Pamela Gwen Wiggins, LCAS LICENSED CLINIC
• William C Rabe DMD PA
• William Milner DDS PA
• Amy Williams, D.D.S.
• Brandon Williams, D.D.S.
• David Goodwin Williams, MD

• Family Nurse Practitioner in Asheboro, NC
• Providers in Asheboro, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.