Individual provider Active NPI

Elizabeth Jenkins Raynor, FNP-BC

  • Family Nurse Practitioner
  • Jacksonville, NC
National Provider Identifier
1275165581
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5012820 Issued in NC
Practice address
250 Huff Dr
Jacksonville, NC 28546-7369
Phone
(910) 353-4414
Fax
(910) 353-2972
NPI assigned
Feb 5, 2020
Last updated
Feb 5, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5012820 NC Primary

Addresses

Primary practice location

250 Huff Dr
Jacksonville, NC 28546-7369

Mailing address

110 Pirates CV
Sneads Ferry, NC 28460-9594
Phone (843) 252-8460

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
I20200427001270 NC Practitioner - Nurse Practitioner 3678903051 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Carolina Anesthesia Associates PLLCGroup PAC ID 5092720813, 691 clinicians

Practice addresses (Care Compare)

1001 W Williams St
Suite 103
Apex, NC 27502-3978
Phone (919) 439-7867

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5012820NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Coast Pain Management Center, PLLC CurrentSince Jul 29, 2022 Accepting new patients
Johnston Pain Management PA CurrentSince Feb 20, 2020 Accepting new patients
East Carolina Anesthesia Associates, PLLC CurrentSince Dec 15, 2024 Accepting new patients
Onslow Memorial Hospital, Inc. CurrentSince Apr 11, 2020 Accepting new patients
Crystal Coast Pain Management Center, PLLC CurrentSince Jul 29, 2022 Accepting new patients

Locations

1001 W Williams St
Ste 103
Apex, NC 27502
Phone (919) 363-2111

2430 Emerald Pl
Ste 103
Greenville, NC 27834
Phone (252) 752-2140

250 Huff Dr
Jacksonville, NC 28546
Phone (910) 353-4414

317 Western Blvd
Jacksonville, NC 28546
Phone (910) 577-2240

57 Office Park Dr
Jacksonville, NC 28546
Phone (910) 353-6008

2111 Neuse Blvd
Ste J
New Bern, NC 28560
Phone (252) 636-0300

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 1

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": "1580860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1275165581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 PIRATES CV",
            "city": "SNEADS FERRY",
            "state": "NC",
            "postal_code": "284609594",
            "telephone_number": "843-252-8460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 HUFF DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467369",
            "telephone_number": "910-353-4414",
            "fax_number": "910-353-2972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYNOR",
        "first_name": "ELIZABETH",
        "middle_name": "JENKINS",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-05",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5012820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.