Individual provider Active NPI

Wendy Shew Shumate, FNP

  • Family Nurse Practitioner
  • Yadkinville, NC
National Provider Identifier
1669446084
Registry record updated Nov 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201391 Issued in NC
Practice address
755 S State St
Yadkinville, NC 27055-7756
Phone
(336) 849-4171
Fax
(336) 849-4170
NPI assigned
Feb 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201391 NC Primary
Nurse Practitioner 363L00000X 201391 NC

Addresses

Primary practice location

755 S State St
Yadkinville, NC 27055-7756

Mailing address

755 S State St
Yadkinville, NC 27055-7756
Phone (336) 849-4171

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
I20110309000069 NC Practitioner - Nurse Practitioner 7911189162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

755 S State St
Yadkinville, NC 27055-7756
Phone (336) 849-4171

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Express Care of Yadkin LLC Family CurrentSince May 1, 2015 Accepting new patients
Mountain View Medical Center Past Accepting new patients
Express Care of Yadkin Past Accepting new patients

Locations

755 S State St
Yadkinville, NC 27055
Phone (336) 849-4171

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1669446084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 S STATE ST",
            "city": "YADKINVILLE",
            "state": "NC",
            "postal_code": "270557756",
            "telephone_number": "336-849-4171",
            "fax_number": "336-849-4170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 S STATE ST",
            "city": "YADKINVILLE",
            "state": "NC",
            "postal_code": "270557756",
            "telephone_number": "336-849-4171",
            "fax_number": "336-849-4170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUMATE",
        "first_name": "WENDY",
        "middle_name": "SHEW",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "201391",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "201391",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yadkinville, NC

Sources for this page

Verify at the official NPI Registry.