Individual provider Active NPI

Breanne Marie Vandevrede, DNP, FNP-C

  • Family Nurse Practitioner
  • Sanford, NC
National Provider Identifier
1437878196
Registry record updated Nov 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5016797 Issued in NC
Practice address
555 Carthage St
Sanford, NC 27330-4104
Phone
(919) 774-6518
NPI assigned
Aug 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5016797 NC Primary

Addresses

Primary practice location

555 Carthage St
Sanford, NC 27330-4104

Mailing address

725 Avenue of the Carolinas
Carthage, NC 28327-0149

Other practice location 1

1821 Hillandale Rd Ste 24A
Durham, NC 27705-2671
Phone (919) 883-4398

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
I20221219001940 NC Practitioner - Nurse Practitioner 2163891870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of North Carolina at Chapel Hill School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinehurst Medical Clinic IncGroup PAC ID 5991617169, 162 clinicians

Practice addresses (Care Compare)

555 Carthage St
Sanford, NC 27330-4104
Phone (919) 774-6518

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5016797NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pinehurst Medical Clinic, Inc. CurrentSince Jan 22, 2024 Accepting new patients
Pinehurst Medical Clinic, Inc. CurrentSince Jan 22, 2024 Accepting new patients
Pinehurst Medical Clinic, Inc. Past Accepting new patients

Locations

205 Page Rd
Pinehurst, NC 28374
Phone (910) 295-9211

555 Carthage St
Sanford, NC 27330
Phone (919) 774-6518

200 Pavilion Way
Southern Pines, NC 28387
Phone (910) 235-3330

Interoperability endpoints

  • Direct secure messaging: breannevandevrede@phmc.allscriptsdirect.net

Organizations & group practices 3

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 4

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": "1661385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700352000000",
    "number": "1437878196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 AVENUE OF THE CAROLINAS",
            "city": "CARTHAGE",
            "state": "NC",
            "postal_code": "283270149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 CARTHAGE ST",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273304104",
            "telephone_number": "919-774-6518"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1821 Hillandale Rd Ste 24A",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277052671",
            "country_code": "US",
            "telephone_number": "919-883-4398",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDEVREDE",
        "first_name": "BREANNE",
        "middle_name": "MARIE",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-25",
        "last_updated": "2023-11-19",
        "certification_date": "2023-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5016797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, NC

Sources for this page

Verify at the official NPI Registry.