Individual provider Active NPI

Elizabeth Renee Eaton, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Wilmington, NC
National Provider Identifier
1245937473
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5017627 Issued in NC
Practice address
2311 Canterwood Dr
Wilmington, NC 28401-7300
Phone
(910) 726-8500
NPI assigned
Feb 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5017627 NC Primary

Addresses

Primary practice location

2311 Canterwood Dr
Wilmington, NC 28401-7300

Mailing address

2311 Canterwood Dr
Wilmington, NC 28401-7300
Phone (910) 726-8500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5017627NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ele-Mental Wellness Corp Psychiatric/Mental Health Current Accepting new patients
David Young Oh, LLC Psychiatric/Mental Health Current Accepting new patients
Mindpath Care Centers, North Carolina, PLLC Psychiatric/Mental Health PastSince Feb 1, 2023 Accepting new patients

Locations

2311 Canterwood Dr
Wilmington, NC 28401
Phone (910) 763-0189

Organizations & group practices 3

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": "1675814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1245937473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 CANTERWOOD DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017300",
            "telephone_number": "910-726-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 CANTERWOOD DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017300",
            "telephone_number": "910-726-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EATON",
        "first_name": "ELIZABETH",
        "middle_name": "RENEE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-08",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5017627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.