Individual provider Active NPI

Shaquithia Monique McKinney, MSN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Goldsboro, NC
National Provider Identifier
1487518650
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5023632 Issued in NC
Practice address
2719 Graves Dr Ste 5
Goldsboro, NC 27534-4536
Phone
(919) 330-4367
Fax
(919) 330-4375
NPI assigned
Dec 12, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5023632 NC Primary

Addresses

Primary practice location

2719 Graves Dr Ste 5
Goldsboro, NC 27534-4536

Mailing address

2719 Graves Dr Ste 5
Goldsboro, NC 27534-4536
Phone (919) 330-4367

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
I20260323000908 NC Practitioner - Nurse Practitioner 5193209724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clientfirst of NC, LLCGroup PAC ID 7517099617, 8 clinicians

Practice addresses (Care Compare)

2719 Graves Dr
Goldsboro, NC 27534-4536
Phone (919) 330-4367

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
5023632NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clientfirst of NC, LLC Psychiatric/Mental Health CurrentSince Dec 14, 2025 Accepting new patients

Locations

2719 Graves Dr
Ste 5
Goldsboro, NC 27534
Phone (919) 330-4367

Organizations & group practices 1

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": "1765497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765497600000",
    "number": "1487518650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2719 GRAVES DR STE 5",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275344536",
            "telephone_number": "919-330-4367",
            "fax_number": "919-330-4375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2719 GRAVES DR STE 5",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275344536",
            "telephone_number": "919-330-4367",
            "fax_number": "919-330-4375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "SHAQUITHIA",
        "middle_name": "MONIQUE",
        "name_prefix": "Miss",
        "credential": "MSN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-12",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5023632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

Verify at the official NPI Registry.