Active NPI
Lucretia P Newkirk, NP
- Family Nurse Practitioner
- Wilmington, NC
National Provider Identifier
1235445982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 5005024
- 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, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250219003718 | NC | Order and Referring Only - Nurse Practitioner | 2769663442 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP9266909 | FL | MD | Registered Nurse |
| APRN-1428 | HI | MD | Registered Nurse |
| 150604 | NC | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Surgical Medical Clinic | Past | Accepting new patients | |
| Goshen Medical Center Incorporated | Past | Accepting new patients | |
| Michael G. Rallis, M.D., PLLC | Past | 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.
-
dba GMC Pharmacy at Rockingham
- Federally Qualified Health Center (FQHC)
- Rockingham, NC
- NPI 1457181323
-
- Internal Medicine Physician
- Hampstead, NC
- NPI 1477721843
-
- Surgery Physician
- Burgaw, NC
- NPI 1417378779
-
dba Hawaii Island Community Health Center
- Federally Qualified Health Center (FQHC)
- Pahoa, HI
- NPI 1861376907
-
- Federally Qualified Health Center (FQHC)
- Kailua Kona, HI
- NPI 1952335630
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; 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.