Individual provider Active NPI

Lori Wheeler, R.N.

  • Psychiatric/Mental Health Nurse Practitioner
  • Jacksonville, NC
National Provider Identifier
1417483439
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5018992 Issued in NC
Practice address
200 Tarpon TRL
Jacksonville, NC 28546-5287
Phone
(580) 565-6707
NPI assigned
May 11, 2017
Last updated
Oct 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5018992 NC Primary
Medical-Surgical Registered Nurse 163WM0705X 0012230 DE

Addresses

Primary practice location

200 Tarpon TRL
Jacksonville, NC 28546-5287

Mailing address

10293 Bradford St
Kingston, OK 73439-2151
Phone (580) 565-6707

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
I20231228001824 NC Practitioner - Nurse Practitioner 1951751205 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Missouri, Columbia School of Medicine, 2023
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Porters Neck Psychological Services PLLCGroup PAC ID 9931394996, 3 clinicians

Practice addresses (Care Compare)

8044 Market St
Unit D
Wilmington, NC 28411-9384
Phone (910) 686-3505

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0012230DEMDMedical-Surgical Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Carolina Neuropsychiatric Center, PA CurrentSince Nov 9, 2023 Accepting new patients
Porters Neck Psychological Services, PLLC CurrentSince Jan 15, 2025 Accepting new patients

Locations

200 Tarpon Trl
Jacksonville, NC 28546
Phone 9109381114139

1630 Military Cutoff Rd
Ste 108
Wilmington, NC 28403

8044 Market St
#D
Wilmington, NC 28411
Phone (910) 686-3505

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": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1417483439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10293 BRADFORD ST",
            "city": "KINGSTON",
            "state": "OK",
            "postal_code": "734392151",
            "telephone_number": "580-565-6707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 TARPON TRL",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465287",
            "telephone_number": "580-565-6707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "LORI",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5018992",
            "primary": true
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "DE",
            "license": "0012230",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.