Individual provider Active NPI

Tonya Denise Hasty, FNP-C

  • Nurse Practitioner
  • Rocky Mount, NC
National Provider Identifier
1346965324
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5017034 Issued in NC
Practice address
111 S Fairview Rd
Rocky Mount, NC 27801-6971
Phone
(252) 212-6810
Fax
(252) 212-3497
NPI assigned
Oct 11, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X HAST-TN20P NC
Primary Care Nurse Practitioner 363LP2300X HAST-TN20P NC
Nurse Practitioner 363L00000X 5017034 NC Primary

Addresses

Primary practice location

111 S Fairview Rd
Rocky Mount, NC 27801-6971

Mailing address

690 Poplar LN
Halifax, NC 27839-7702
Phone (252) 578-4255

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
I20221117002225 NC Practitioner - Nurse Practitioner 1759759087 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
HAST-TN20PNCMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Opportunities Industrialization Center, Inc. CurrentSince Oct 26, 2022 Accepting new patients
Opportunities Industrialization Center, Inc CurrentSince Oct 26, 2022 Accepting new patients
Opportunities Industrialization Center, Inc CurrentSince Oct 26, 2022 Accepting new patients

Locations

300 N Grace St
Rocky Mount, NC 27804
Phone (252) 210-9856

111 S Fairview Rd
Rocky Mount, NC 27801
Phone (252) 212-3486

1041 Noell Ln
#B
Rocky Mount, NC 27804
Phone (252) 962-3450

2309 Sunset Ave
Rocky Mount, NC 27804
Phone (252) 210-9856

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": "1665446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1346965324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 POPLAR LN",
            "city": "HALIFAX",
            "state": "NC",
            "postal_code": "278397702",
            "telephone_number": "252-578-4255",
            "fax_number": "252-212-3497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S FAIRVIEW RD",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278016971",
            "telephone_number": "252-212-6810",
            "fax_number": "252-212-3497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASTY",
        "first_name": "TONYA",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-11",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "HAST-TN20P",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "HAST-TN20P",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5017034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, NC

Sources for this page

Verify at the official NPI Registry.