Individual provider Active NPI

Cynthia Dixon Grant, FNP-C

  • Family Nurse Practitioner
  • Jacksonville, NC
National Provider Identifier
1649771536
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5010179 Issued in NC
Practice address
306 Brynn Marr Rd
Jacksonville, NC 28546-7023
Phone
(910) 353-6406
NPI assigned
Feb 26, 2018
Last updated
May 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5010179 NC Primary

Addresses

Primary practice location

306 Brynn Marr Rd
Jacksonville, NC 28546-7023

Mailing address

205 Vesta CT
Surf City, NC 28445-6546
Phone (910) 620-1967

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
I20180420001469 NC Practitioner - Nurse Practitioner 0941563175 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5010179NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Star Medical Clinic PLLC CurrentSince Mar 12, 2018 Accepting new patients
NMG Health Services LLC CurrentSince May 1, 2021 Accepting new patients
Novant Health Medical Group Coastal Region, LLC Current Accepting new patients
Novant Health Medical Group Coastal Region, LLC CurrentSince May 1, 2021 Accepting new patients

Locations

461 Western Blvd
Ste 122
Jacksonville, NC 28546
Phone (910) 333-0283

1333 S Dickinson Dr
Unit 110
Leland, NC 28451
Phone (910) 399-6543

800 Jefferson St
Ste 112
Whiteville, NC 28472
Phone (910) 642-8164

1809 Glen Meade Rd
Wilmington, NC 28403
Phone (910) 763-9833

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

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.

NPI Registry JSON

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

{
    "created_epoch": "1519603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1649771536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 VESTA CT",
            "city": "SURF CITY",
            "state": "NC",
            "postal_code": "284456546",
            "telephone_number": "910-620-1967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 BRYNN MARR RD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467023",
            "telephone_number": "910-353-6406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "CYNTHIA",
        "middle_name": "DIXON",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-26",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5010179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.