Individual provider Active NPI

Juanita Frazier Perkins, FNP

  • Nurse Practitioner
  • Fayetteville, NC
National Provider Identifier
1386609568
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN085691 Issued in GA
Practice address
810 Elm St
Fayetteville, NC 28303-4152
Phone
(910) 491-1089
Fax
(833) 973-5477
NPI assigned
Apr 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN085691 GA Primary

Addresses

Primary practice location

810 Elm St
Fayetteville, NC 28303-4152

Mailing address

810 Elm St
Fayetteville, NC 28303-4152
Phone (910) 491-1089

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
I20250815004177 NC Practitioner - Nurse Practitioner 0244553097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

810 Elm St
Fayetteville, NC 28303-4152

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN085691GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kog Integrated Healthcare CurrentSince May 31, 2025 Accepting new patients

Locations

810 Elm St
Fayetteville, NC 28303
Phone (910) 321-0356

Interoperability endpoints

  • Direct secure messaging: juanita.perkins.1@30455.direct.athenahealth.com

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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1386609568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 ELM ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283034152",
            "telephone_number": "910-491-1089",
            "fax_number": "833-973-5477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 ELM ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283034152",
            "telephone_number": "910-491-1089",
            "fax_number": "833-973-5477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERKINS",
        "first_name": "JUANITA",
        "middle_name": "FRAZIER",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-19",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN085691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.