Individual provider Active NPI

Jennifer Needs Demartino Harrison, DO

  • Family Medicine Physician
  • Nags Head, NC
National Provider Identifier
1265929681
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2021-01507 Issued in NC
Practice address
2917 S Croatan Hwy
Nags Head, NC 27959-9027
Phone
(954) 873-7044
NPI assigned
Apr 20, 2018
Last updated
Aug 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2021-01507 NC Primary

Addresses

Primary practice location

2917 S Croatan Hwy
Nags Head, NC 27959-9027

Mailing address

PO Box 1776
Nags Head, NC 27959-1776
Phone (252) 423-4300

Other practice location 1

943 US Highway 64
Manteo, NC 27954-9537
Phone (954) 873-7044

Other practice location 2

305 Back Rd
Ocracoke, NC 27960-1007
Phone (252) 925-7000

Other practice location 3

33270 US Hwy 264
Engelhard, NC 27824
Phone (252) 925-7000

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210726000407 NC Practitioner - Family Practice 8224431564 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Campbell Univ School of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2917 S Croatan Hwy
Nags Head, NC 27959-9027
Phone (252) 216-2791

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Croatan Family Medicine, P.C. CurrentSince Jun 20, 2024 Accepting new patients
Ocracoke Health Center, Inc. CurrentSince Jul 10, 2023 Accepting new patients
Surf Pediatrics and Medicine PC CurrentSince Apr 1, 2022 Accepting new patients
Ocracoke Health Center, Inc. CurrentSince Sep 15, 2022 Accepting new patients
Eastern Radiologists Inc PastSince Mar 1, 2022 Accepting new patients

Locations

400 S Croatan Hwy
Kill Devil Hills, NC 27948
Phone (252) 441-7870

5107 N Croatan Hwy
Kitty Hawk, NC 27949
Phone (252) 255-5321

100 E Dune St
Nags Head, NC 27959
Phone (252) 449-5200

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1524182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1265929681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1776",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "279591776",
            "telephone_number": "252-423-4300",
            "fax_number": "252-862-2684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2917 S CROATAN HWY",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "279599027",
            "telephone_number": "954-873-7044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "943 US Highway 64",
            "address_purpose": "LOCATION",
            "city": "Manteo",
            "state": "NC",
            "postal_code": "279549537",
            "country_code": "US",
            "telephone_number": "954-873-7044",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "305 Back Rd",
            "address_purpose": "LOCATION",
            "city": "Ocracoke",
            "state": "NC",
            "postal_code": "279601007",
            "country_code": "US",
            "telephone_number": "252-925-7000",
            "fax_number": "252-925-7700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "33270 US Hwy 264",
            "address_purpose": "LOCATION",
            "city": "Engelhard",
            "state": "NC",
            "postal_code": "27824",
            "country_code": "US",
            "telephone_number": "252-925-7000",
            "fax_number": "252-925-7700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "JENNIFER",
        "middle_name": "NEEDS DEMARTINO",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-20",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2021-01507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nags Head, NC

Sources for this page

Verify at the official NPI Registry.