Destiny Total Healthcare, PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

DESTINY TOTAL HEALTHCARE, PLLC

Practice address

407 Fremont Street
Burgaw, NC 28425

Phone

(910) 900-5411

NPI assigned

Oct 8, 2020

Organization subpart

No

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

Authorized official

Name

Tonia Whitley Gray, NURSE PRACTITIONERNPI 1659891232

Title

Owner

Phone

(910) 259-3489

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22707/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tonia Whitley Gray, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Burgaw, NC
  • NPI 1659891232
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606694400000",
    "number": "1487251807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 E FREMONT ST",
            "city": "BURGAW",
            "state": "NC",
            "postal_code": "284255129",
            "telephone_number": "910-259-3489",
            "fax_number": "910-259-3492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 FREMONT STREET",
            "city": "BURGAW",
            "state": "NC",
            "postal_code": "28425",
            "telephone_number": "910-900-5411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTINY TOTAL HEALTHCARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-08",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "TONIA",
        "authorized_official_middle_name": "WHITLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-259-3489",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Frederick Darkus, O.D.
• Larry J Dashow, MD
• Emily Day, COTA/L
• Austin James Degroff, OD
• Rebecca W Denson, ARNP
• Elizabeth Ann Seton Diehl, LCSWA
• Gregory Wayne Dion, PA
• Jennifer Suber Dixon
• Sara Sanderson Dodgens, LCAS, LCSW
• David Neil Downing, RPH

• Primary Care Clinic/Center in Burgaw, NC
• Providers in Burgaw, NC by specialty
• Primary Care Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.