Individual provider Active NPI

Rebekah Jordan McCarthy, FNP

  • Family Nurse Practitioner
  • Statesville, NC
National Provider Identifier
1679054779
Registry record updated Sep 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5010972 Issued in NC
Practice address
1804 Davie Ave
Statesville, NC 28677-3524
Phone
(704) 873-7250
NPI assigned
Aug 27, 2018
Last updated
Sep 12, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2018

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 5010972 NC Primary
Registered Nurse 163W00000X 151883 NC

Addresses

Primary practice location

1804 Davie Ave
Statesville, NC 28677-3524

Mailing address

PO Box 1845
Statesville, NC 28687-1845
Phone (704) 873-4277

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
I20181113000661 NC Practitioner - Nurse Practitioner 5496009391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Healthcare PAGroup PAC ID 9638070683, 226 clinicians

Practice addresses (Care Compare)

1804 Davie Ave
Statesville, NC 28677-3524
Phone (704) 873-7250

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
151883NCMDRegistered Nurse
5010972NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Healthcare, PA CurrentSince Sep 24, 2018 Accepting new patients
Piedmont Healthcare, P.a. CurrentSince Sep 24, 2018 Accepting new patients

Locations

1804 Davie Ave
Statesville, NC 28677
Phone (704) 873-7250

208 Old Mocksville Rd
Statesville, NC 28625
Phone (704) 838-8215

650 Signal Hill Drive Ext
Statesville, NC 28625
Phone (704) 873-4277

Organizations & group practices 2

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 1

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": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536710400000",
    "number": "1679054779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1845",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286871845",
            "telephone_number": "704-873-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 DAVIE AVE",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773524",
            "telephone_number": "704-873-7250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "REBEKAH",
        "middle_name": "JORDAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-27",
        "last_updated": "2018-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5010972",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "151883",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

Verify at the official NPI Registry.