Stanton W Ezzell, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

300311 Issued in NC

Practice address

703 Newman Rd
New Bern, NC 28562-5239

Phone

(252) 635-5290

Fax

(252) 633-9609

NPI assigned

Nov 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407920739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 NEWMAN RD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285625239",
            "telephone_number": "252-635-5290",
            "fax_number": "252-633-9609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 NEWMAN RD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285625239",
            "telephone_number": "252-635-5290",
            "fax_number": "252-633-9609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZZELL",
        "first_name": "STANTON",
        "middle_name": "W",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "300311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC MEDICAL LICENSE",
            "identifier": "300311",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine J. Everett, MD
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• Jessica Faiella
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• Ozie Trevor Faison Jr., RPH
• Faith in Family Therapy,NC

• Pediatric Nurse Practitioner in New Bern, NC
• Providers in New Bern, NC by specialty
• Pediatric Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.