NPIMap

Individual provider Active NPI

Wana M Gulledge, FNP-C

  • Family Nurse Practitioner
  • Henderson, NC
National Provider Identifier
1295468221
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
GULL-Y239T Issued in NC
Practice address
480 Ruin Creek Rd
Henderson, NC 27536-2929
Phone
(252) 492-3152
NPI assigned
Jul 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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 GULL-Y239T NC Primary

Addresses

Primary practice location

480 Ruin Creek Rd
Henderson, NC 27536-2929

Mailing address

480 Ruin Creek Rd
Henderson, NC 27536-2929
Phone (252) 492-3152

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230206000754 NC Practitioner - Nurse Practitioner 3072985837 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Duke University Affiliated Physicians, Inc.Group PAC ID 3779489588, 452 clinicians

Practice addresses (Care Compare)

1490 Williamsboro St
Oxford, NC 27565-3498
Phone (919) 693-3972

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Durham, NC, CCN 347110
  • Duke Regional Hospital Hospital, Durham, NC, CCN 340155
  • Maria Parham Medical Center Hospital, Henderson, NC, CCN 340132
  • Duke University Hospital Hospital, Durham, NC, CCN 340030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
GULL-Y239TNCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Affiliated Physicians, Inc. Family Medicine CurrentSince Feb 6, 2023 Accepting new patients
Duke University Affiliated Physicians, Inc. Family Medicine CurrentSince Feb 6, 2023 Accepting new patients
Duke University Affiliated Physicians, Inc. Family Medicine Current Accepting new patients

Locations

480 Ruin Creek Rd
Henderson, NC 27536
Phone (252) 492-3152

1490 Williamsboro St
Oxford, NC 27565
Phone (919) 693-3972

Interoperability endpoints

  • Direct secure messaging: wlucate52679@direct.medicine.duke.edu

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.

Hospital & facility affiliations 11

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": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1295468221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 RUIN CREEK RD",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275362929",
            "telephone_number": "252-492-3152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 RUIN CREEK RD",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275362929",
            "telephone_number": "252-492-3152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULLEDGE",
        "first_name": "WANA",
        "middle_name": "M",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-07",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "GULL-Y239T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NC

Sources for this page

Verify at the official NPI Registry.