NPIMap

Organization Active NPI

Simpleclinic PLLC

  • Primary Care Nurse Practitioner
  • Clinton, NC
National Provider Identifier
1255998944
Registry record updated May 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
SIMPLECLINIC PLLC
Practice address
1515 Sunset Ave
Clinton, NC 28328-3827
Phone
(910) 491-9418
Fax
(866) 488-6433
NPI assigned
May 29, 2019
Last updated
May 31, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2019

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

Authorized official

Name
Jonathan Daniel Hancock, NPNPI 1780816223
Title
Owner/Provider
Phone
(910) 491-4530

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X NU Primary

Addresses

Primary practice location

1515 Sunset Ave
Clinton, NC 28328-3827

Mailing address

PO Box 727
Stedman, NC 28391-0727

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Simpleclinic PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559260800000",
    "number": "1255998944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 727",
            "city": "STEDMAN",
            "state": "NC",
            "postal_code": "283910727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 SUNSET AVE",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283283827",
            "telephone_number": "910-491-9418",
            "fax_number": "866-488-6433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMPLECLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-29",
        "last_updated": "2019-05-31",
        "status": "A",
        "authorized_official_last_name": "HANCOCK",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "910-491-4530",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.