Mary Ann Todd, AGNP
Individual provider Active NPI Adult Health Nurse Practitioner · Wagram, NC
NPI 1326665142 · NPPES record last updated Nov 13, 2024
Key facts
- NPI
- 1326665142
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- 5014125 (NC)
- Practice address
- 24420 Marlboro St
Wagram, NC 28396-9600 - Phone
- (910) 369-3136
- Fax
- (910) 504-8515
- NPI assigned
- Jun 27, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 18
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Scotland Memorial Hospital, Inc
Practice addresses (Care Compare)
24420 Marlboro St
Wagram, NC 28396-9600
Phone (910) 369-3136
Hospital & facility affiliations
- Scotland Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210506000252 | NC | Practitioner - Nurse Practitioner | 1254740186 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5014125 | NC | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Goshen Medical Center, Inc. | Current |
Accepting new patients | |
| Goshen Medical Center Incorporated | Current | Accepting new patients | |
| Scotland Memorial Hospital Inc | Current |
Accepting new patients | |
| Goshen Medical Center, Incorporated | Current | Accepting new patients | |
| Goshen Medical Center Incorporated | Current |
Accepting new patients | |
| Scotland Memorial Hospital Inc | Current |
Accepting new patients | |
| Harris Family Practice PLLC | Family Medicine | Past | Accepting new patients |
| Goshen Medical Center Incorporated | Past | Accepting new patients |
Locations
444 SW Center St
Faison, NC 28341
Phone (910) 267-0421
3613 Cape Center Dr
Fayetteville, NC 28304
Phone (910) 354-1720
500 Lauchwood Dr
Laurinburg, NC 28352
Phone (856) 848-3227
125 Biltmore Dr
Ste 1
Rockingham, NC 28379
Phone (910) 719-3666
103 Cotton Creek Rd
Star, NC 27356
Phone (910) 226-4970
24420 Marlboro St
Wagram, NC 28396
Phone (910) 369-3136
Interoperability endpoints
- mtodd@goshenmedical.cloudcraftdirect.com
- mtodd297329@carolinashealthcaresystem.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5014125 | NC | |
| Adult Health Nurse Practitioner | 363LA2200X | 5014125 | NC | Yes |
Addresses
Primary practice location
24420 Marlboro St
Wagram, NC 28396-9600
Mailing address
24420 Marlboro St
Wagram, NC 28396-9600
Phone (910) 369-3136
Other providers in Wagram, NC
- Scotland Memorial Hospital, Inc
- Scotland Regional Health Network
- Southern Heart Home Care
- Sunshine Center
- Sunshine Center, Inc.
- Terri Reno Weber
- Taneka M Williams
All providers in Wagram, NC · Adult Health Nurse Practitioner in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.