Jacqueline Farrell Ploszak, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5007369 Issued in NC

Practice address

4815 Berewick Town Center Dr Ste C&D
Charlotte, NC 28278-6733

Phone

(980) 337-4652

Fax

(980) 337-4653

NPI assigned

Dec 8, 2014

Last updated

Jul 14, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolina Medicorp Enterprises LLCGroup PAC ID 0648174904, 184 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations (25 of 30)

Interoperability endpoints

• Direct secure messaging: jploszak45509@direct.novanthealth.org

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.

• Carolina Medicorp Enterprises, LLC

  dba Novant Health GoHealth Urgent Care

  • Urgent Care Clinic/Center
  • Charlotte, NC
  • NPI 1760950646
  Medicare reassignment Care Compare group NPD
• Minuteclinic Diagnostic of North Carolina PC

  • Family Nurse Practitioner
  • Raleigh, NC
  • NPI 1699748608
  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  dba Novant Health Endocrinology

  • Endocrinology, Diabetes & Metabolism Physician
  • Charlotte, NC
  • NPI 1306950282
  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  dba Novant Health Pediatric Neurology & Sleep

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment NPD
• Carolina Medicorp Enterprises, Inc

  dba Prime Care of Greensboro

  • Family Medicine Physician
  • Greensboro, NC
  • NPI 1154389088

  Nurse Practitioner

  NPD
• Carolina Medicorp Enterprises, LLC

  dba Novant Health GoHealth Urgent Care

  • Urgent Care Clinic/Center
  • Asheville, NC
  • NPI 1235014796
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Lakeside Family Physicians

  • Family Medicine Physician
  • Cornelius, NC
  • NPI 1356394308
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Elizabeth OB/GYN

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Urology Partners

  • Urology Physician
  • Leland, NC
  • NPI 1700329778
  NPD
• Carolina Medicorp Enterprises Inc

  dba Prime Care of North Point

  • Nurse Practitioner
  • Winston Salem, NC
  • NPI 1053379933
  NPD (past)

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

{
    "created_epoch": "1417996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1649678624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601843",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 BEREWICK TOWN CENTER DR STE C&D",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282786733",
            "telephone_number": "980-337-4652",
            "fax_number": "980-337-4653"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11300 Cresthill Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Mint Hill",
            "state": "NC",
            "postal_code": "282277924",
            "country_code": "US",
            "telephone_number": "704-438-9479",
            "fax_number": "704-438-9478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PLOSZAK",
        "first_name": "JACQUELINE",
        "middle_name": "FARRELL",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-08",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5007369",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5007369",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jploszak45509@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "4815 Berewick Town Center Dr Ste C&d",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282786733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Plese and Priester PLLC
• Alison Nicole Pleva, NP
• Michael Thomas Pleva, CRNA
• James W. Plonk, MD
• John Bulter Plonk Jr., MD
• Stefan A Ploszak, DDS
• Thomas Michael Plott, PH.D.
• Abigail Plowcha, DC
• Janiya Simone Plowden, PA-C
• PLR Services

• Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.