Individual provider Active NPI

Kathryn Wriggelsworth, DNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Durham, NC
National Provider Identifier
1407162050
Registry record updated Feb 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
195204 Issued in NC
Practice address
910 Broad St
Durham, NC 27705-4142
Phone
(919) 416-4191
NPI assigned
Aug 20, 2010
Last updated
Feb 13, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 195204 NC Primary

Addresses

Primary practice location

910 Broad St
Durham, NC 27705-4142

Mailing address

910 Broad St
Durham, NC 27705-4142
Phone (919) 416-4191

Other identifiers 2

IdentifierTypeStateIssuer
5004868OtherNCNC LICENSE
6113123MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Inner Peace Psychological Services and Integrative Wellness Center Psychiatric/Mental Health CurrentSince Aug 1, 2012 Accepting new patients
Logan Graddy MD PLLC Past Accepting new patients

Locations

102 Towerview Ct
Cary, NC 27513
Phone (919) 594-6510

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, 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": "1282262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423785600000",
    "number": "1407162050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 BROAD ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054142",
            "telephone_number": "919-416-4191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 BROAD ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054142",
            "telephone_number": "919-416-4191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGGELSWORTH",
        "first_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "DNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-20",
        "last_updated": "2015-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "195204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC LICENSE",
            "identifier": "5004868",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6113123",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.