Individual provider Active NPI

Jessica Velissa Watts, NP

  • Family Nurse Practitioner
  • Lumberton, NC
National Provider Identifier
1487176368
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5020822 Issued in NC
Practice address
2901 N Elm St
Lumberton, NC 28358-2982
Phone
(910) 671-5395
Fax
(910) 739-3062
NPI assigned
Jul 12, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 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 5020822 NC Primary

Addresses

Primary practice location

2901 N Elm St
Lumberton, NC 28358-2982

Mailing address

2901 N Elm St
Lumberton, NC 28358-2982
Phone (910) 671-5395

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwatts1217763@direct.UNC.nchie.net Direct

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
I20241024001899 NC Practitioner - Nurse Practitioner 3274928957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Unc Physicians Network LLCGroup PAC ID 5496940546, 985 clinicians

Practice addresses (Care Compare)

2901 N Elm St
Lumberton, NC 28358-2982
Phone (910) 671-5395

Hospital & facility affiliations

  • Southeastern Regional Medical Center Hospital, Lumberton, NC, CCN 340050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5020822NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Unc Physicians Network LLC Current Accepting new patients
Unc Physicians Network LLC CurrentSince Oct 13, 2024 Accepting new patients

Locations

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-5123

2901 N Elm St
Lumberton, NC 28358
Phone (910) 671-5395

5221 Paramount Pkwy
Ste 220
Morrisville, NC 27560
Phone (984) 215-4110

Interoperability endpoints

  • Direct secure messaging: jwatts1217763@direct.unc.nchie.net

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.

Hospital & facility affiliations 1

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": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1487176368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 N ELM ST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283582982",
            "telephone_number": "910-671-5395",
            "fax_number": "910-739-3062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 N ELM ST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283582982",
            "telephone_number": "910-671-5395",
            "fax_number": "910-739-3062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "JESSICA",
        "middle_name": "VELISSA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-12",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5020822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwatts1217763@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "2901 N Elm St",
            "city": "Lumberton",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283582982",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lumberton, NC

Sources for this page

Verify at the official NPI Registry.