Stephanie Renee Brathwaite, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5007050 Issued in NC

Practice address

294 N Highway 16
Ste. B
Denver, NC 28037-8011

Phone

(704) 483-8105

NPI assigned

May 21, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Stephanie Renee Roberts Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 29, 2018 through Oct 29, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Carolina Eneregtics PC

  • Addiction (Substance Use Disorder) Counselor
  • Salisbury, NC
  • NPI 1649783200
  NPD (past)

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439424000000",
    "number": "1548520935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 681789",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370681789",
            "telephone_number": "615-503-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 N HIGHWAY 16",
            "address_2": "STE. B",
            "city": "DENVER",
            "state": "NC",
            "postal_code": "280378011",
            "telephone_number": "704-483-8105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRATHWAITE",
        "first_name": "STEPHANIE",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-21",
        "last_updated": "2015-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5007050",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5007050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548520935",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "ROBERTS",
            "middle_name": "RENEE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gina Margaret Benson, PHARMD
• Steve Robert Benson, LPC
• Misti G Benton, NP
• Daniel T. Biondi, D.O.
• Blue Mist Psychotherapy, PLLC
• Gifty Brew-Thompson
• Katherine Bridges, ITFS, QP-P
• Amber Brooks, DDS
• Ryan Scott Brooks, M.D.
• Shannon Kelly Brooks, COTA/L

• Nurse Practitioner in Denver, NC
• Providers in Denver, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.