Jordan Rebecca Wattenburger, DNP, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5014862 Issued in NC

Practice address

403 Fairview St
Clinton, NC 28328-2399

Phone

(910) 592-6011

NPI assigned

May 18, 2021

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 names 1

• Jordan Rebecca Tysinger Former name

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clinton Medical Clinic, Inc.Group PAC ID 6406821628, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Liberty Home Care Home health agency, Dunn, NC, CCN 347306
• Sampson Regional Medical Center Hospital, Clinton, NC, CCN 340024

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Clinton Medical Clinic, Inc.

  • General Practice Physician
  • Clinton, NC
  • NPI 1780629154

  Family

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Liberty Healthcare Group, LLC

  • Home Health Agency
  • Dunn, NC
  • NPI 1366498834
  Care Compare affiliation
• Sampson Regional Medical Center

  • General Acute Care Hospital
  • Clinton, NC
  • NPI 1609857432
  Care Compare affiliation

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1568036069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 FAIRVIEW ST",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283282311",
            "telephone_number": "910-592-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 FAIRVIEW ST",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283282399",
            "telephone_number": "910-592-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTENBURGER",
        "first_name": "JORDAN",
        "middle_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-18",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "246720",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5014862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jordanwattenburger@cmci.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "Clinton Medical Clinic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "403 Fairview St",
            "city": "Clinton",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283282399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "TYSINGER",
            "middle_name": "REBECCA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael Andrew Wall, PA-C
• Warren Joe Bell
• Faye F. Warren, FNP
• Phillip Henry Warren IV, P.T.
• Karika Partilia Watkins-Hill, PA
• Lawrence J. Watts, MD
• Tyhena Weatherall, NP
• Jamie Alysse Weiner, DNP, FNP-C
• Scott Werner, P.T., D.P.T.
• Westbrook Medical Services, PLLC

• Family Nurse Practitioner in Clinton, NC
• Providers in Clinton, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; 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.
• 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.