Individual provider Active NPI

Beverly Belk Wilson, FNP-BC

  • Family Nurse Practitioner
  • Clinton, NC
National Provider Identifier
1376908194
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5008343 Issued in NC
Practice address
360 County Complex Rd
Clinton, NC 28328-4845
Phone
(615) 585-6699
NPI assigned
Dec 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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 5008343 NC Primary

Addresses

Primary practice location

360 County Complex Rd
Clinton, NC 28328-4845

Mailing address

360 County Complex Rd Ste 200
Clinton, NC 28328-4846
Phone (615) 585-6699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160422000785 NC Practitioner - Nurse Practitioner 6901105154 Reassigns benefits to 1 organization
I20180621002125 TN Practitioner - Nurse Practitioner 6901105154

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Quickcare Family Practice, PLLCGroup PAC ID 0840682340, 107 clinicians

Practice addresses (Care Compare)

2265 NC Hwy 24 27 E
Biscoe, NC 27209-9758
Phone (919) 828-1131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5008343NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Quickcare Family Practice, PLLC CurrentSince Feb 16, 2024 Accepting new patients

Locations

2265 NC Highway 24 27 E
Biscoe, NC 27209
Phone (919) 810-0054

4612 Main St
Shallotte, NC 28470
Phone (910) 444-2970

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1450656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1376908194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 COUNTY COMPLEX RD STE 200",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283284846",
            "telephone_number": "615-585-6699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 COUNTY COMPLEX RD",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283284845",
            "telephone_number": "615-585-6699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BEVERLY",
        "middle_name": "BELK",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-21",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5008343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, NC

Sources for this page

Verify at the official NPI Registry.