Individual provider Active NPI

Lucretia P Newkirk, NP

  • Family Nurse Practitioner
  • Wilmington, NC
National Provider Identifier
1235445982
Registry record updated Nov 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5005024 Issued in NC
Practice address
1709 S 16TH St Ste a
Wilmington, NC 28401-6491
Phone
(910) 452-8633
Fax
(910) 452-8569
NPI assigned
Aug 19, 2010
Last updated
Nov 13, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2018

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5005024 NC Primary
Registered Nurse 163W00000X APRN-1428 HI
Registered Nurse 163W00000X 201509106RN OR
Registered Nurse 163W00000X 150604 NC
Registered Nurse 163W00000X ARNP9266909 FL

Addresses

Primary practice location

1709 S 16TH St Ste a
Wilmington, NC 28401-6491

Mailing address

PO Box 15109
Wilmington, NC 28408-5109
Phone (910) 392-2525

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
I20250219003718 NC Order and Referring Only - Nurse Practitioner 2769663442

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9266909FLMDRegistered Nurse
APRN-1428HIMDRegistered Nurse
150604NCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Medical Clinic Past Accepting new patients
Goshen Medical Center Incorporated Past Accepting new patients
Michael G. Rallis, M.D., PLLC PastSince May 8, 2022 Accepting new patients
West Hawaii Community Health Center, Inc. Past Accepting new patients
West Hawaii Community Health Center, Inc. Past Accepting new patients

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": "1282176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542067200000",
    "number": "1235445982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15109",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284085109",
            "telephone_number": "910-392-2525",
            "fax_number": "910-392-2827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 S 16TH ST STE A",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016491",
            "telephone_number": "910-452-8633",
            "fax_number": "910-452-8569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWKIRK",
        "first_name": "LUCRETIA",
        "middle_name": "P",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-19",
        "last_updated": "2018-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5005024",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "HI",
            "license": "APRN-1428",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201509106RN",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "150604",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "ARNP9266909",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.