Individual provider Active NPI

Debra Baker Beasley, FNP

  • Family Nurse Practitioner
  • Lumberton, NC
National Provider Identifier
1568458495
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
200855 Issued in NC
Practice address
4901 Dawn Dr Ste 3200
Lumberton, NC 28360-8288
Phone
(910) 735-8040
NPI assigned
Sep 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 200855 NC Primary

Addresses

Primary practice location

4901 Dawn Dr Ste 3200
Lumberton, NC 28360-8288

Mailing address

5221 Paramount Pkwy Ste 220
Morrisville, NC 27560-5490

Other identifiers 1

IdentifierTypeStateIssuer
200855OtherNCNC MEDICAL BOARD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dbeasley212485@direct.UNC.nchie.net Direct

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
I20171025000281 NC Practitioner - Nurse Practitioner 2466728159 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
200855NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Unc Physicians Network LLC Current Accepting new patients
Southeastern Regional Physician Services CurrentSince Aug 30, 2017 Accepting new patients
Unc Physicians Network LLC CurrentSince Jun 1, 2022 Accepting new patients
Southeastern Regional Physician Services CurrentSince Aug 30, 2017 Accepting new patients
Carolina Acute Care & Wellness Center, PA Past Accepting new patients

Locations

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-5123

295 W 27th St
Lumberton, NC 28358
Phone (910) 739-5550

2002 N Cedar St
#B
Lumberton, NC 28358
Phone (910) 272-3048

4901 Dawn Dr
Ste 3200
Lumberton, NC 28360
Phone (910) 735-8040

395 W 27th St
Lumberton, NC 28358
Phone (910) 738-3434

4300 Fayetteville Rd
Lumberton, NC 28358
Phone (910) 608-3078

5221 Paramount Pkwy
Ste 220
Morrisville, NC 27560
Phone (984) 215-4110

Interoperability endpoints

  • Direct secure messaging: dbeasley212485@direct.unc.nchie.net
  • FHIR API: https://api.platform.athenahealth.com/21718/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1568458495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5221 PARAMOUNT PKWY STE 220",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275605490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 DAWN DR STE 3200",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283608288",
            "telephone_number": "910-735-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEASLEY",
        "first_name": "DEBRA",
        "middle_name": "BAKER",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-26",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "200855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC MEDICAL BOARD",
            "identifier": "200855",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dbeasley212485@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "295 W 27th St",
            "city": "Lumberton",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283583016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lumberton, NC

Sources for this page

Verify at the official NPI Registry.