NPIMap

Individual provider Active NPI

Athena Nicole Pickenpack-Cousar, NP

  • Nurse Practitioner
  • Greensboro, NC
National Provider Identifier
1417427188
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5011168 Issued in NC
Practice address
1200 N Elm St
Greensboro, NC 27401-1004
Phone
(336) 832-1000
NPI assigned
Nov 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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 5011168 NC Primary

Addresses

Primary practice location

1200 N Elm St
Greensboro, NC 27401-1004

Mailing address

PO Box 1737
Jamestown, NC 27282-1737
Phone (336) 543-8212

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address apickenpackcousar13962@direct.conehealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190207001428 NC Practitioner - Nurse Practitioner 9638417124 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1200 N Elm St
Greensboro, NC 27401-1004
Phone (336) 832-7000

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 718-7597

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5011168NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Sep 18, 2021 Accepting new patients
Moses Cone Physician Services, Inc. CurrentSince Jan 7, 2019 Accepting new patients
Moses Cone Physician Services Inc CurrentSince Jan 7, 2019 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Sep 18, 2021 Accepting new patients
Moses Cone Physician Services, Inc. Nurse Practitioner Current Accepting new patients
Moses Cone Physician Services Inc Past Accepting new patients

Locations

2400 W Friendly Ave
Greensboro, NC 27403
Phone (336) 832-1100

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

1750 Kernersville Medical Pkwy
Kernersville, NC 27284
Phone (336) 564-4000

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1417427188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1737",
            "city": "JAMESTOWN",
            "state": "NC",
            "postal_code": "272821737",
            "telephone_number": "336-543-8212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N ELM ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011004",
            "telephone_number": "336-832-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKENPACK-COUSAR",
        "first_name": "ATHENA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-26",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5011168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apickenpackcousar13962@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "Cone Health Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1200 N Elm St",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274011004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.