Individual provider Active NPI

Ingrit Kolpeja

  • Nurse Practitioner
  • Bolivia, NC
National Provider Identifier
1679106413
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5012852 Issued in NC
Practice address
240 Hospital Dr NE
Bolivia, NC 28422-8346
Phone
(910) 721-1000
NPI assigned
Feb 20, 2020
Last updated
Oct 26, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5012852 NC Primary
Family Nurse Practitioner 363LF0000X 5012852 NC

Addresses

Primary practice location

240 Hospital Dr NE
Bolivia, NC 28422-8346

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (910) 721-2070

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ikolpeja198302@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
I20200416003052 NC Practitioner - Nurse Practitioner 9739519653 Reassigns benefits to 2 organizations

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
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

240 Hospital Dr NE
Bolivia, NC 28422-8346
Phone (910) 721-1330

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5012852NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 7, 2020 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 7, 2020 Accepting new patients
NMG Health Services LLC CurrentSince Nov 11, 2024 Accepting new patients
Novant Health Medical Group Coastal Region, LLC Current Accepting new patients
Novant Health Medical Group Coastal Region, LLC CurrentSince Nov 11, 2024 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients
New Hanover Medical Group PA Past Accepting new patients

Locations

240 Hospital Dr NE
Bolivia, NC 28422
Phone (336) 399-7678

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

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

109 Scotts Hill Medical Dr
Fl 1
Wilmington, NC 28411
Phone (910) 662-1730

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 8

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": "1582156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1679106413",
    "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",
            "telephone_number": "910-721-2070",
            "fax_number": "910-721-2074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 HOSPITAL DR NE",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284228346",
            "telephone_number": "910-721-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLPEJA",
        "first_name": "INGRIT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-20",
        "last_updated": "2020-10-26",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5012852",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5012852",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ikolpeja198302@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "240 Hospital Dr NE",
            "city": "Bolivia",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284228346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bolivia, NC

Sources for this page

Verify at the official NPI Registry.