Individual provider Active NPI

Kathy Jo Asbury, ARNP

  • Family Nurse Practitioner
  • Supply, NC
National Provider Identifier
1356598619
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5004946 Issued in NC
Practice address
610 Ocean Hwy W
Supply, NC 28462-4048
Phone
(910) 253-5885
Fax
(910) 253-5887
NPI assigned
Aug 19, 2008
Last updated
Jan 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5004946 NC Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 46254 KS
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5004946 NC

Addresses

Primary practice location

610 Ocean Hwy W
Supply, NC 28462-4048

Mailing address

PO Box 281
Bolivia, NC 28422-0281
Phone (910) 253-5885

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
I20110105001120 NC Practitioner - Nurse Practitioner 1456411073 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moving Ahead Counseling ServicesGroup PAC ID 7911369327, 6 clinicians

Practice addresses (Care Compare)

610 Ocean Hwy W
Supply, NC 28462-4048
Phone (910) 253-5885

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5004946NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Southeastern United Care LLC CurrentSince May 13, 2017 Accepting new patients
Moving Ahead Counseling Services Psychiatric/Mental Health CurrentSince Sep 12, 2023 Accepting new patients
Coastal Southeastern United Care LLC Past Accepting new patients

Locations

10 Referendum Dr NE
#F115
Bolivia, NC 28422
Phone (910) 253-5801

3640 Express Dr
Shallotte, NC 28470
Phone (910) 294-8471

610 Ocean Hwy W
Supply, NC 28462
Phone (910) 253-5885

100 Memory Plz
#A
Whiteville, NC 28472
Phone (910) 640-2230

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, 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": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1356598619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 281",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284220281",
            "telephone_number": "910-253-5885",
            "fax_number": "910-253-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 OCEAN HWY W",
            "city": "SUPPLY",
            "state": "NC",
            "postal_code": "284624048",
            "telephone_number": "910-253-5885",
            "fax_number": "910-253-5887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASBURY",
        "first_name": "KATHY",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-19",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5004946",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "46254",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5004946",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Supply, NC

Sources for this page

Verify at the official NPI Registry.