Individual provider Active NPI

Jacob Anthony Farnsworth, DNP, FNP

  • Family Nurse Practitioner
  • Jacksonville, NC
National Provider Identifier
1336839968
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5018204 Issued in NC
Practice address
1000 Brabham Ave
Jacksonville, NC 28546-5003
Phone
(910) 347-1515
NPI assigned
May 8, 2023
Last updated
Jun 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Nurse Practitioner 363LF0000X 5018204 NC Primary

Addresses

Primary practice location

1000 Brabham Ave
Jacksonville, NC 28546-5003

Mailing address

1202 Medical Center Dr
Wilmington, NC 28401-7307
Phone (910) 341-1540

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
I20230711001373 NC Practitioner - Nurse Practitioner 3678932472 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wilmington Health PLLCGroup PAC ID 6103722509, 364 clinicians

Practice addresses (Care Compare)

1000 Brabham LN
Jacksonville, NC 28546-5003
Phone (910) 341-1540

1202 Medical Ctr Dr
Wilmington, NC 28401-7307
Phone (910) 341-1540

1222 Medical Ctr Dr
Wilmington, NC 28401-7307
Phone (910) 341-1540

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5018204NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wilmington ASC LLC CurrentSince Aug 1, 2023 Accepting new patients
Wilmington Health PLLC CurrentSince Aug 1, 2023 Accepting new patients

Locations

1000 Brabham Ave
Jacksonville, NC 28546
Phone (910) 347-1515

1202 Medical Center Dr
Wilmington, NC 28401
Phone (910) 617-6705

Interoperability endpoints

  • Direct secure messaging: jacob.farnsworth.p1@direct.wilmingtonhealth.nextgenshare.com

Organizations & group practices 2

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 3

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": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1336839968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017307",
            "telephone_number": "910-341-1540",
            "fax_number": "910-431-4048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BRABHAM AVE",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465003",
            "telephone_number": "910-347-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARNSWORTH",
        "first_name": "JACOB",
        "middle_name": "ANTHONY",
        "credential": "DNP, FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-08",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5018204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.