Individual provider Active NPI

Stephanie K McLaughlin, NP-BC

  • Gerontology Nurse Practitioner
  • Fayetteville, NC
National Provider Identifier
1326632811
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
5014260 Issued in NC
Practice address
4048 Ardenwoods Dr
Fayetteville, NC 28306-9310
Phone
(910) 745-5211
NPI assigned
Feb 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Registered Nurse 163WR0400X 149239 NC
Gerontology Nurse Practitioner 363LG0600X 5014260 NC Primary

Addresses

Primary practice location

4048 Ardenwoods Dr
Fayetteville, NC 28306-9310

Mailing address

4048 Ardenwoods Dr
Fayetteville, NC 28306-9310
Phone (910) 745-5211

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
I20260402001512 NC Order and Referring Only - Nurse Practitioner 4385048669

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149239NCMDRehabilitation Registered Nurse
5014260NCMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1614124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1326632811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4048 ARDENWOODS DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283069310",
            "telephone_number": "910-745-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4048 ARDENWOODS DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283069310",
            "telephone_number": "910-745-5211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLAUGHLIN",
        "first_name": "STEPHANIE",
        "middle_name": "K",
        "credential": "NP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-24",
        "last_updated": "2021-04-14",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Rehabilitation",
            "state": "NC",
            "license": "149239",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NC",
            "license": "5014260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.