Individual provider Active NPI

Kaitlin Tucker, FNP

  • Family Nurse Practitioner
  • Jacksonville, NC
National Provider Identifier
1487453981
Registry record updated Oct 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5021796 Issued in NC
Practice address
612 College St
Jacksonville, NC 28540-5311
Phone
(910) 347-2154
NPI assigned
Mar 10, 2025
Last updated
Oct 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5021796 NC Primary
Family Nurse Practitioner 363LF0000X 0035757 OH

Addresses

Primary practice location

612 College St
Jacksonville, NC 28540-5311

Mailing address

612 College St
Jacksonville, NC 28540-5311
Phone (910) 347-2154

Other names 1

  • Kaitlin Ream Former name

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
I20250403000987 NC Practitioner - Nurse Practitioner 8628592318 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0035757OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lower Cape Fear Hospice, Inc CurrentSince Mar 17, 2025 Accepting new patients
County of Onslow CurrentSince Mar 17, 2025 Accepting new patients
County of Onslow Past Accepting new patients

Locations

612 College St
Jacksonville, NC 28540
Phone (910) 347-2154

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, 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": "1741564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792454400000",
    "number": "1487453981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 COLLEGE ST",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285405311",
            "telephone_number": "910-347-2154",
            "fax_number": "910-347-3165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 COLLEGE ST",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285405311",
            "telephone_number": "910-347-2154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "KAITLIN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-10",
        "last_updated": "2026-10-20",
        "certification_date": "2026-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5021796",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0035757",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLIN",
            "last_name": "REAM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.