Individual provider Active NPI

Jennifer Fernandez Berry

  • Family Nurse Practitioner
  • Pinehurst, NC
National Provider Identifier
1679930291
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5008322 Issued in NC
Practice address
145 Applecross Rd
Pinehurst, NC 28374-8521
Phone
(910) 692-7928
NPI assigned
Jan 27, 2016
Last updated
Sep 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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 5008322 NC Primary

Addresses

Primary practice location

145 Applecross Rd
Pinehurst, NC 28374-8521

Mailing address

145 Applecross Rd
Pinehurst, NC 28374-8521
Phone (910) 692-7928

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
I20160330002422 NC Practitioner - Nurse Practitioner 7810294238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.49 of 100Reported as group
Quality
98.47
Promoting interoperability
81
Improvement activities
40
Cost
88.99

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5008322NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MCPC-12, LLC CurrentSince May 10, 2021 Accepting new patients
MCPC-12, LLC CurrentSince May 10, 2021 Accepting new patients
Texan Urgent Care PLLC Past Accepting new patients

Locations

5 First Village Dr
Ste 100
Pinehurst, NC 28374
Phone (910) 692-7928

313 Teal Dr
Raeford, NC 28376
Phone (910) 904-2350

110 Medical Cir
Rockingham, NC 28379
Phone (910) 410-9494

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, 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": "1453852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1679930291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 APPLECROSS RD",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748521",
            "telephone_number": "910-692-7928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 APPLECROSS RD",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748521",
            "telephone_number": "910-692-7928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "JENNIFER",
        "middle_name": "FERNANDEZ",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-27",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5008322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinehurst, NC

Sources for this page

Verify at the official NPI Registry.