Individual provider Active NPI

Cassaundra Houston Hefner, FNP-BC

  • Nurse Practitioner
  • Shallotte, NC
National Provider Identifier
1306081468
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5004196 Issued in NC
Practice address
5145 Sellers Rd
Shallotte, NC 28470
Phone
(910) 754-4441
NPI assigned
Dec 3, 2008
Last updated
Oct 26, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5004196 NC Primary
Family Nurse Practitioner 363LF0000X 5004196 NC

Addresses

Primary practice location

5145 Sellers Rd
Shallotte, NC 28470

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (844) 266-8268

Other practice location 1

21 18th Ave NW
Hickory, NC 28601-1822
Phone (828) 267-2246

Other practice location 2

21 18th Ave NW
Hickory, NC 28601-1822
Phone (828) 267-2246

Other identifiers 1

IdentifierTypeStateIssuer
891192RMedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address chefner688398@direct.novanthealth.org

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
I20090311000661 NC Practitioner - Nurse Practitioner 6507922861 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, shared by 14 NPIs, 2,413 clinicians

Practice addresses (Care Compare)

3009 Medical Plaza LN
Southport, NC 28461-5194
Phone (910) 457-3827

512 Village Rd
Suite 103
Shallotte, NC 28470-3409
Phone (910) 754-4441

5145 Sellers Rd
Shallotte, NC 28470-3405
Phone (910) 754-4441

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5004196NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Frye Medical Group LLC CurrentSince Jun 1, 2017 Accepting new patients
J. Arthur Dosher Memorial Hospital CurrentSince Apr 3, 2024 Accepting new patients
J. Arthur Dosher Memorial Hospital Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
J. Arthur Dosher Memorial Hospital CurrentSince Apr 3, 2024 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jan 7, 2019 Accepting new patients
DLP Frye Medical Group LLC Nurse Practitioner CurrentSince Jun 1, 2017 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Mar 13, 2022 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jan 7, 2019 Accepting new patients
Fryecare Physicians , LLC Past Accepting new patients

Locations

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

1105 Fairgrove Church Rd SE
Conover, NC 28613
Phone (828) 267-0551

415 N Center St
Ste 203
Hickory, NC 28601
Phone (828) 322-2005

915 Tate Blvd SE
Ste 182
Hickory, NC 28602
Phone (828) 322-2005

915 Tate Blvd SE
Ste 186
Hickory, NC 28602
Phone (828) 449-8458

512 Village Rd
Ste 103
Shallotte, NC 28470
Phone (910) 754-4441

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

3009 Medical Plaza Ln
Southport, NC 28461
Phone (910) 454-1234

823 N Atlantic Ave
Southport, NC 28461
Phone (910) 457-3827

905 N Howe St
Southport, NC 28461
Phone (910) 457-3827

924 N Howe St
Southport, NC 28461
Phone (910) 457-3800

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: chefner688398@direct.novanthealth.org

Organizations & group practices 11

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 5

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": "1228262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1306081468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "844-266-8268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5145 SELLERS RD",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "28470",
            "telephone_number": "910-754-4441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 18th Ave NW",
            "address_purpose": "LOCATION",
            "city": "Hickory",
            "state": "NC",
            "postal_code": "286011822",
            "country_code": "US",
            "telephone_number": "828-267-2246",
            "fax_number": "828-267-1623",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21 18th Ave NW",
            "address_purpose": "LOCATION",
            "city": "Hickory",
            "state": "NC",
            "postal_code": "286011822",
            "country_code": "US",
            "telephone_number": "828-267-2246",
            "fax_number": "828-267-1623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEFNER",
        "first_name": "CASSAUNDRA",
        "middle_name": "HOUSTON",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-03",
        "last_updated": "2020-10-26",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5004196",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5004196",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891192R",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chefner688398@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "21 18th Ave NW",
            "city": "Hickory",
            "state": "NC",
            "country_code": "US",
            "postal_code": "286011822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shallotte, NC

Sources for this page

Verify at the official NPI Registry.