Individual provider Active NPI

Jessica Marie Haselman, FNP

  • Nurse Practitioner
  • Roanoke Rapids, NC
National Provider Identifier
1235694076
Registry record updated Feb 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5011440 Issued in NC
Practice address
1385 Medical Center Dr
Roanoke Rapids, NC 27870-5130
Phone
(252) 537-9176
NPI assigned
Feb 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5011440 NC Primary

Addresses

Primary practice location

1385 Medical Center Dr
Roanoke Rapids, NC 27870-5130

Mailing address

712 Virginia Ave
Roanoke Rapids, NC 27870-2267
Phone (252) 532-5062

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
I20190326002917 NC Practitioner - Nurse Practitioner 9931449147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

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

State licenses

LicenseStateTypeSpecialty
5011440NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Abode Care Partners LTC VB, LLC Nurse Practitioner CurrentSince Jul 7, 2021 Accepting new patients
Vidant Medical Group LLC CurrentSince Jun 1, 2021 Accepting new patients
Vidant Medical Group LLC CurrentSince Jun 1, 2021 Accepting new patients
Abode Care Partners LTC VB, LLC Nurse Practitioner CurrentSince Jul 7, 2021 Accepting new patients

Locations

805 N Whittington Pkwy
Ste 400
Louisville, KY 40222
Phone (502) 272-3438

805 N Whittington Pkwy
Northfield, KY 40222
Phone (502) 627-7000

604 Stokes St E
Ahoskie, NC 27910
Phone (252) 332-2126

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

1385 Medical Center Dr
Roanoke Rapids, NC 27870
Phone (252) 537-9176

305 E 14th St
Roanoke Rapids, NC 27870
Phone (252) 537-6181

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549411200000",
    "number": "1235694076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 VIRGINIA AVE",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278702267",
            "telephone_number": "252-532-5062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1385 MEDICAL CENTER DR",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278705130",
            "telephone_number": "252-537-9176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASELMAN",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-06",
        "last_updated": "2019-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5011440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke Rapids, NC

Sources for this page

Verify at the official NPI Registry.