Jenna Caso
Individual provider Active NPI Family Nurse Practitioner · Tarboro, NC
NPI 1609698703 · NPPES record last updated Oct 29, 2024
Key facts
- NPI
- 1609698703
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 5021045 (NC)
- Practice address
- 110 Western Blvd
Tarboro, NC 27886-4858 - Phone
- (252) 774-4250
- NPI assigned
- Oct 29, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mainstreet and Kidsstreet of North Carolina PLLC
Fastmed PC
Practice addresses (Care Compare)
130 James Ave
Locust, NC 28097-4506
Phone (704) 296-4508
2503 Forest Hills Rd W
Suite B
Wilson, NC 27893-3392
Phone (252) 991-0555
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250122001043 | NC | Practitioner - Nurse Practitioner | 6709315690 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5021045 | NC | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainstreet and Kidsstreet of North Carolina PLLC | Current |
Accepting new patients | |
| Mainstreet and Kidsstreet of North Carolina PLLC | Current |
Accepting new patients | |
| Mainstreet and Kidsstreet of North Carolina PLLC | Current |
Accepting new patients | |
| Mainstreet and Kidsstreet of North Carolina PLLC | Current |
Accepting new patients |
Locations
1500 1st Ave N
Unit 3
Birmingham, AL 35203
Phone (205) 545-5088
130 James Ave
Locust, NC 28097
Phone (704) 271-3777
110 Western Blvd
Tarboro, NC 27886
Phone (252) 774-4250
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 5021045 | NC | Yes |
Addresses
Primary practice location
110 Western Blvd
Tarboro, NC 27886-4858
Mailing address
1500 1St Ave N Unit 3
Birmingham, AL 35203-1866
Phone (205) 545-5088
Other providers in Tarboro, NC
- Caring Hearts, Inc.
- Marcy L Carlini
- Carolina Family Health Centers Inc
- Carolina Family Health Centers, Inc
- Carolina Regional Orthopaedics, PA
- Ashlea M Causey
- Alvah C Cayton IV
- Austin Charlebois
- Isolda Vanessa Chavarria
- Kendall Griffin Clark
All providers in Tarboro, NC · Family Nurse Practitioner in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.