Individual provider Active NPI

Anna Grace Stephenson, FNP

  • Family Nurse Practitioner
  • Erwin, NC
National Provider Identifier
1306675079
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5020646 Issued in NC
Practice address
25 Professional Park
Erwin, NC 28339-9105
Phone
(910) 292-4097
NPI assigned
Jul 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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 5020646 NC Primary

Addresses

Primary practice location

25 Professional Park
Erwin, NC 28339-9105

Mailing address

412 S Eastwood Dr
Benson, NC 27504-9355
Phone (919) 247-4090

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
I20241111000259 NC Practitioner - Nurse Practitioner 7315471661 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palmetto Infusion Services LLCGroup PAC ID 4688578826, 60 clinicians

Practice addresses (Care Compare)

130 James Ave
Locust, NC 28097-4506
Phone (704) 296-4508

4325 Lake Boone TRL
Suite 100
Raleigh, NC 27607-7510
Phone (800) 809-1265

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5020646NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mainstreet and Kidsstreet of North Carolina PLLC CurrentSince Jul 22, 2024 Accepting new patients
Mainstreet and Kidsstreet of North Carolina PLLC CurrentSince Jul 22, 2024 Accepting new patients
Palmetto Infusion Services LLC CurrentSince Jul 7, 2025 Accepting new patients

Locations

1500 1st Ave N
Unit 3
Birmingham, AL 35203
Phone (205) 545-5088

25 Professional Park
Erwin, NC 28339
Phone (910) 292-4097

130 James Ave
Locust, NC 28097
Phone (704) 271-3777

11009 Ingleside Pl
Ste 202
Raleigh, NC 27614

4325 Lake Boone Trl
Ste 100
Raleigh, NC 27607

1551 Westbrook Plaza Dr
Ste 100
Winston Salem, NC 27103
Phone (743) 999-7220

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.

NPI Registry JSON

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

{
    "created_epoch": "1722297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1306675079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 S EASTWOOD DR",
            "city": "BENSON",
            "state": "NC",
            "postal_code": "275049355",
            "telephone_number": "919-247-4090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 PROFESSIONAL PARK",
            "city": "ERWIN",
            "state": "NC",
            "postal_code": "283399105",
            "telephone_number": "910-292-4097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "ANNA",
        "middle_name": "GRACE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-30",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5020646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erwin, NC

Sources for this page

Verify at the official NPI Registry.