Individual provider Active NPI

Stephanie Enzor Ivey, FNP

  • Family Nurse Practitioner
  • Wilmington, NC
National Provider Identifier
1336406503
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5005590 Issued in NC
Practice address
2739 Iron Gate Dr
Wilmington, NC 28412-3731
Phone
(910) 763-7363
Fax
(910) 251-8296
NPI assigned
Apr 12, 2012
Last updated
Feb 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 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 5005590 NC Primary

Addresses

Primary practice location

2739 Iron Gate Dr
Wilmington, NC 28412-3731

Mailing address

2739 Iron Gate Dr
Wilmington, NC 28412-3731
Phone (910) 763-7363

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
I20120609000011 NC Practitioner - Nurse Practitioner 6800050527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wilmington Surgical Associates PAGroup PAC ID 0749186575, 9 clinicians

Practice addresses (Care Compare)

1414 Medical Ctr Dr
Wilmington, NC 28401-7505
Phone (910) 763-7363

Merit-based Incentive Payment System (MIPS)

Final score
79.8 of 100Reported as group
Quality
46.35
Promoting interoperability
97
Improvement activities
40
Cost
88.83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5005590NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wilmington Surgical Associates PA CurrentSince Apr 23, 2012 Accepting new patients

Locations

1414 Medical Center Dr
Wilmington, NC 28401
Phone (910) 763-7363

2739 Iron Gate Dr
Wilmington, NC 28412
Phone (910) 763-7363

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11560/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/BFAIBD
  • Direct secure messaging: stephanie.ivey@wilmsurg.eclinicaldirectplus.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1336406503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2739 IRON GATE DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284123731",
            "telephone_number": "910-763-7363",
            "fax_number": "910-251-8296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2739 IRON GATE DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284123731",
            "telephone_number": "910-763-7363",
            "fax_number": "910-251-8296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVEY",
        "first_name": "STEPHANIE",
        "middle_name": "ENZOR",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-12",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5005590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.