Active NPI
Bonita C Aycock, FNP
- Nurse Practitioner
- Spring Hope, NC
National Provider Identifier
1619961620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 200892
- Practice address
- 100 Dodd St
Spring Hope, NC 27882-9348 - Phone
- (252) 478-5412
- Fax
- (252) 937-3100
- NPI assigned
- Sep 6, 2005
- Last updated
- Mar 7, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 200892 | NC | Primary |
Addresses
Primary practice location
100 Dodd St
Spring Hope, NC 27882-9348
Mailing address
PO Box 7200
Rocky Mount, NC 27804-0200
Phone (252) 937-0200
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 363L00000X | Other | NC | TAXONOMY |
| 500005810 | Other | NC | RAILROAD MEDICARE |
| 7000422 | Medicaid | NC | |
| 58594 | Other | NC | MEDICAL LICENSE |
| 1619961620 | Other | NC | NPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200892 | NC | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1619961620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7200",
"city": "ROCKY MOUNT",
"state": "NC",
"postal_code": "278040200",
"telephone_number": "252-937-0200",
"fax_number": "252-451-0056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 DODD ST",
"city": "SPRING HOPE",
"state": "NC",
"postal_code": "278829348",
"telephone_number": "252-478-5412",
"fax_number": "252-937-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AYCOCK",
"first_name": "BONITA",
"middle_name": "C",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-06",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "200892",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAXONOMY",
"identifier": "363L00000X",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "500005810",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7000422",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "58594",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1619961620",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Spring Hope, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.