Individual provider Active NPI

Jennifer Suzanne Blevins, NP

  • Nurse Practitioner
  • Leland, NC
National Provider Identifier
1629424742
Registry record updated Jan 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5008622 Issued in NC
Practice address
501 Olde Waterford Way
Leland, NC 28451-4117
Phone
(910) 408-1130
Fax
(910) 408-1135
NPI assigned
May 7, 2016
Last updated
Jan 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5008622 NC Primary

Addresses

Primary practice location

501 Olde Waterford Way
Leland, NC 28451-4117

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

5717 Albemarle Rd
Charlotte, NC 28212-1634
Phone (704) 563-2150

Other practice location 2

7810 Providence Rd
Suite 102
Charlotte, NC 28226-2954
Phone (704) 543-6636

Other practice location 3

5727 Prosperity Crossing Dr
Suite 1100
Charlotte, NC 28269-2206
Phone (704) 863-9930

Other practice location 4

501 Olde Waterford Way
Leland, NC 28451-4117
Phone (910) 408-1130

Other practice location 5

1090 NE Gateway Ct NE
Suite 202
Concord, NC 28025-2414
Phone (704) 403-9050

Other practice location 6

10210 Couloak Dr
Suite E
Charlotte, NC 28216-7679
Phone (704) 801-2000

Other practice location 7

319 Village Rd NE
Leland, NC 28451-7417
Phone (910) 721-1197

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwhite393037@direct.novanthealth.org

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
I20160907002286 NC Practitioner - Nurse Practitioner 7012203672 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

501 Olde Waterford Way
Leland, NC 28451-4117
Phone (910) 721-4370

5145 Sellers Rd
Shallotte, NC 28470-3405
Phone (910) 754-4572

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5008622NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Care - Urgent Care and Sports Medicine CurrentSince Jul 14, 2019 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Medical Group, Inc. CurrentSince Oct 1, 2020 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

3603 Davis Dr
Ste 105
Morrisville, NC 27560
Phone (919) 500-2005

1904 Jake Alexander Blvd W
Ste 301
Salisbury, NC 28147
Phone (704) 638-1551

6832 Market St
#A
Wilmington, NC 28405
Phone (910) 242-3514

Interoperability endpoints

  • Direct secure messaging: jwhite393037@direct.novanthealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1462579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767312000000",
    "number": "1629424742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 OLDE WATERFORD WAY",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284514117",
            "telephone_number": "910-408-1130",
            "fax_number": "910-408-1135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5717 Albemarle Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282121634",
            "country_code": "US",
            "telephone_number": "704-563-2150",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7810 Providence Rd",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282262954",
            "country_code": "US",
            "telephone_number": "704-543-6636",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5727 Prosperity Crossing Dr",
            "address_2": "Suite 1100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282692206",
            "country_code": "US",
            "telephone_number": "704-863-9930",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 Olde Waterford Way",
            "address_purpose": "LOCATION",
            "city": "Leland",
            "state": "NC",
            "postal_code": "284514117",
            "country_code": "US",
            "telephone_number": "910-408-1130",
            "fax_number": "910-408-1135",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1090 NE Gateway Ct NE",
            "address_2": "Suite 202",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252414",
            "country_code": "US",
            "telephone_number": "704-403-9050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10210 Couloak Dr",
            "address_2": "Suite E",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282167679",
            "country_code": "US",
            "telephone_number": "704-801-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "319 Village Rd NE",
            "address_purpose": "LOCATION",
            "city": "Leland",
            "state": "NC",
            "postal_code": "284517417",
            "country_code": "US",
            "telephone_number": "910-721-1197",
            "fax_number": "910-721-1199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLEVINS",
        "first_name": "JENNIFER",
        "middle_name": "SUZANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-07",
        "last_updated": "2026-01-02",
        "certification_date": "2026-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5008622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwhite393037@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "319 Village Rd NE",
            "city": "Leland",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284517417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Leland, NC

Sources for this page

Verify at the official NPI Registry.