Individual provider Active NPI

Nicholas Allen Jernigan, M.D.

  • Pediatrics Physician
  • Hampstead, NC
National Provider Identifier
1376797472
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2010-00748 Issued in NC
Practice address
20 Southend CT BLDG 9
Hampstead, NC 28443-7013
Phone
(910) 270-3673
NPI assigned
Nov 17, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2010-00748 NC Primary
Internal Medicine Physician 207R00000X 2010-00748 NC

Addresses

Primary practice location

20 Southend CT BLDG 9
Hampstead, NC 28443-7013

Mailing address

20 Southend CT
Hampstead, NC 28443-7013
Phone (910) 270-3673

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100928001511 NC Practitioner - Pediatric MedicinePractitioner - Internal Medicine 3375669252 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2010-00748NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kidzcare Pediatrics, PC Pediatrics Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1226880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1376797472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 SOUTHEND CT",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "284437013",
            "telephone_number": "910-270-3673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 SOUTHEND CT BLDG 9",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "284437013",
            "telephone_number": "910-270-3673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERNIGAN",
        "first_name": "NICHOLAS",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-17",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2010-00748",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2010-00748",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampstead, NC

Sources for this page

Verify at the official NPI Registry.