NPIMap

Individual provider Active NPI

Erica Mathis Shore, FNP

  • Nurse Practitioner
  • North Wilkesboro, NC
National Provider Identifier
1609428887
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5011954 Issued in NC
Practice address
1370 W D St
North Wilkesboro, NC 28659-3506
Phone
(336) 716-2255
NPI assigned
Jul 9, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5011954 NC Primary
Family Nurse Practitioner 363LF0000X 5011954 NC

Addresses

Primary practice location

1370 W D St
North Wilkesboro, NC 28659-3506

Mailing address

1370 W D St
North Wilkesboro, NC 28659-3506
Phone (336) 903-7900

Other practice location 1

306 College St
Wilkesboro, NC 28697-2854
Phone (336) 651-7533

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190925003917 NC Practitioner - Nurse Practitioner 8729318209 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Practice addresses (Care Compare)

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

  • Wilkes Regional Medical Center Hospital, North Wilkesboro, NC, CCN 340064
  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Aug 17, 2022 Accepting new patients
Wake Forest University Health Sciences CurrentSince May 19, 2020 Accepting new patients
County of Wilkes CurrentSince Aug 12, 2019 Accepting new patients
Wake Forest University Health Sciences CurrentSince May 19, 2020 Accepting new patients
County of Wilkes Current Accepting new patients

Locations

1370 W D St
North Wilkesboro, NC 28659
Phone (336) 651-8100

555 Fayetteville St
Raleigh, NC 27601
Phone (682) 268-1011

306 College St
Wilkesboro, NC 28697
Phone (336) 651-7450

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: eshore2753543@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 20

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.

View all 20

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1562630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1609428887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 W D ST",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286593506",
            "telephone_number": "336-903-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 W D ST",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286593506",
            "telephone_number": "336-716-2255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "306 College St",
            "address_purpose": "LOCATION",
            "city": "Wilkesboro",
            "state": "NC",
            "postal_code": "286972854",
            "country_code": "US",
            "telephone_number": "336-651-7533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHORE",
        "first_name": "ERICA",
        "middle_name": "MATHIS",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-09",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5011954",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5011954",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Wilkesboro, NC

Sources for this page

Verify at the official NPI Registry.