Individual provider Active NPI

Karen Watson Vickers, MSN, RN, FNP-C

  • Family Nurse Practitioner
  • Durham, NC
National Provider Identifier
1598039539
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024185207 Issued in VA
Practice address
2530 Meridian Pkwy Ste 300
Durham, NC 27713-5273
Phone
(984) 257-7565
Fax
(984) 257-0190
NPI assigned
Mar 7, 2012
Last updated
Jun 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 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 0024185207 VA Primary

Addresses

Primary practice location

2530 Meridian Pkwy Ste 300
Durham, NC 27713-5273

Mailing address

10208 Cerny St Ste 210
Raleigh, NC 27617-7885
Phone (919) 457-0340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20240627000553 VA Practitioner - Nurse Practitioner 6901037613 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
0024185207VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Universal Health Corporation CurrentSince May 4, 2024 Accepting new patients

Locations

1945 Roanoke Blvd
Salem, VA 24153
Phone (540) 345-3094

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, 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": "1331078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1598039539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10208 CERNY ST STE 210",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276177885",
            "telephone_number": "919-457-0340",
            "fax_number": "919-806-8878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 MERIDIAN PKWY STE 300",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277135273",
            "telephone_number": "984-257-7565",
            "fax_number": "984-257-0190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERS",
        "first_name": "KAREN",
        "middle_name": "WATSON",
        "name_prefix": "Mrs.",
        "credential": "MSN, RN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-07",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024185207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.