Individual provider Active NPI

Mildreth Sisco, FNP-C, ENP-C

  • Family Nurse Practitioner
  • Fort Bragg, NC
National Provider Identifier
1447653670
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5007057 Issued in NC
Practice address
2817 Rock Merritt Ave
Fort Bragg, NC 28310-3424
Phone
(910) 907-8922
Fax
(910) 907-6069
NPI assigned
Oct 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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 5007057 NC Primary

Addresses

Primary practice location

2817 Rock Merritt Ave
Fort Bragg, NC 28310-3424

Mailing address

2817 Rock Merritt Avenue Attn: Managed Care Planning
Fort Bragg, NC 28310-3424
Phone (910) 907-8922

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141121002054 NC Practitioner - Nurse Practitioner 5395067698 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5007057NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hoke Emergency Group, PC CurrentSince Aug 25, 2017 Accepting new patients
Bladen Medical Associates PastSince Mar 24, 2025 Accepting new patients

Locations

210 Medical Pavilion Dr
Raeford, NC 28376
Phone (910) 904-8000

Interoperability endpoints

  • Direct secure messaging: msisco32529@capefearvalley.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1412208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1447653670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVENUE ATTN: MANAGED CARE PLANNING",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283103424",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283103424",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISCO",
        "first_name": "MILDRETH",
        "credential": "FNP-C, ENP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-02",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5007057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bragg, NC

Sources for this page

Verify at the official NPI Registry.