Individual provider Active NPI

Brenda Belk Cupp, FNP

  • Nurse Practitioner
  • Salisbury, NC
National Provider Identifier
1407063282
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5003012 Issued in NC
Practice address
1930 Jake Alexander Blvd W Ste 1020
Salisbury, NC 28147-1269
Phone
(704) 870-8108
Fax
(704) 870-8110
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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 5003012 NC
Family Nurse Practitioner 363LF0000X 3106 SC
Nurse Practitioner 363L00000X 5003012 NC Primary

Addresses

Primary practice location

1930 Jake Alexander Blvd W Ste 1020
Salisbury, NC 28147-1269

Mailing address

1930 Jake Alexander Blvd W Ste 1020
Salisbury, NC 28147-1269
Phone (704) 870-8108

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
I20080130000115 NC Practitioner - Nurse Practitioner 6709968795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ultra Violet Mental HealthGroup PAC ID 2365792074, 5 clinicians

Practice addresses (Care Compare)

1930 Jake Alexander Blvd W
Suite 1020
Salisbury, NC 28147-1269
Phone (704) 870-8108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5003012NCMDNurse Practitioner
3106SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Community Services Enterprise Family Current 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": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1407063282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 JAKE ALEXANDER BLVD W STE 1020",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281471269",
            "telephone_number": "704-870-8108",
            "fax_number": "704-870-8110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 JAKE ALEXANDER BLVD W STE 1020",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281471269",
            "telephone_number": "704-870-8108",
            "fax_number": "704-870-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUPP",
        "first_name": "BRENDA",
        "middle_name": "BELK",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5003012",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "3106",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5003012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, NC

Sources for this page

Verify at the official NPI Registry.